J Health Care Poor Underserved. 2024;35(4):1206-1228. doi: 10.1353/hpu.2024.a943986.
Black and Latine Americans face the highest HIV burden among U.S. racial and ethnic groups, exacerbated by intersectional stigma and medical mistrust. We conducted 21 interviews with Black and Latine HIV care consumers between November-December 2021, investigating their views on medical mistrust and experiences of stigma. Key drivers of mistrust included perceptions of providers not prioritizing patient interests, perceived dishonesty, and doubts about their competence. In addition, participants highlighted a lack of individualized care, no partnership in decision making, insufficient follow-up, and overall institutional mistrust. Participants felt judged based on their HIV status and observed race and ethnicity- based disparities in care outcomes. In response to mistrust, they either switched providers or self- advocated. These insights may guide the creation of interventions to tackle medical mistrust among providers.
黑人和拉丁裔美国人面临着美国种族和族裔群体中最高的 HIV 负担,这种情况因交叉歧视和医疗不信任而加剧。我们在 2021 年 11 月至 12 月期间对 21 名黑人和拉丁裔 HIV 护理消费者进行了采访,调查了他们对医疗不信任和歧视经历的看法。不信任的主要驱动因素包括提供者不优先考虑患者利益、被认为不诚实以及对其能力的怀疑。此外,参与者还强调缺乏个性化护理、决策中没有合作伙伴关系、随访不足以及对整个机构的不信任。参与者觉得自己因 HIV 状况而受到评判,并观察到护理结果存在基于种族和族裔的差异。为了应对不信任,他们要么更换提供者,要么自行主张。这些观点可能有助于制定干预措施,以解决提供者中的医疗不信任问题。