Department of Psychological Sciences, University of Connecticut, Storrs, CT, United States.
Institute for Collaboration on Health, Intervention and Policy (InCHIP), University of Connecticut, Storrs, CT, United States.
J Behav Med. 2023 Dec;46(6):897-911. doi: 10.1007/s10865-023-00417-7. Epub 2023 Sep 12.
Medical mistrust is fueled by conspiracy theories and histories of healthcare systems abuse and is a known determinant of health outcomes in minority populations. Plagued by multiple and pervasive conspiracy theories, HIV/AIDS has proven to be particularly hampered by medical mistrust. The current paper systematically reviews the literature on medical mistrust among people at risk for or living with HIV infection. The bulk of evidence from 17 studies supports medical mistrust as a barrier to HIV testing, engagement in prevention and care services, treatment uptake and adherence, and clinical outcomes. While findings mostly indicate that medical mistrust is a barrier to HIV prevention and care, some studies report null results and others suggest that medical mistrust may actually improve some HIV-related outcomes. Additionally, most of the reviewed literature was cross-sectional. Thus longitudinal, theory-driven research is needed to reconcile inconsistent findings and determine long term outcomes of medical mistrust. Interventions may then be developed to reduce the negative consequences associated with medical mistrust.
医学不信任是由阴谋论以及医疗体系滥用的历史所助长的，并且是少数族裔人群健康结果的已知决定因素。受多种普遍存在的阴谋论的困扰，艾滋病毒/艾滋病已被证明特别受到医学不信任的阻碍。本文系统地回顾了针对有感染艾滋病毒风险或患有艾滋病毒的人群的医学不信任的文献。来自 17 项研究的大量证据表明，医学不信任是艾滋病毒检测、参与预防和护理服务、治疗接受和坚持以及临床结果的障碍。虽然研究结果大多表明医学不信任是艾滋病毒预防和护理的障碍，但有些研究报告结果为零，而另一些研究则表明医学不信任实际上可能改善某些与艾滋病毒相关的结果。此外，大多数被审查的文献都是横断面研究。因此，需要进行纵向、基于理论的研究，以调和不一致的研究结果，并确定医学不信任的长期后果。然后可以制定干预措施来减少与医学不信任相关的负面后果。
