Minority Health Archive

Discrimination, Distrust, and Racial/Ethnic Disparities in Antiretroviral Therapy Adherence Among a National Sample of HIV-Infected Patients

Thrasher, Angela D. and Earp, Jo Anne L. and Golin, Carol E. and Zimmer, Catherine R. (2008) Discrimination, Distrust, and Racial/Ethnic Disparities in Antiretroviral Therapy Adherence Among a National Sample of HIV-Infected Patients. Journal of Acquired Immune Deficiency Syndromes, 49 (1). pp. 84-93.

Full text not available from this repository.

Abstract

Objective: Although discriminatory health care experiences and health care provider distrust have been shown to be associated with health care disparities, little is known about their contribution to racial/ethnic disparities in antiretroviral therapy adherence. We therefore sought to assess the extent to which discriminatory health care experiences and health care provider distrust influence treatmentrelated attitudes, beliefs, and self-reported adherence in a national sample of HIV-infected patients. Study Design: This secondary analysis used data from the HIV Cost and Services Utilization Study. We used structural equation modeling to identify pathways from minority status to adherence through discrimination, distrust, and treatment-related attitudes and beliefs. Participants: The sample was the 1886 participants who completed the baseline and 2 follow-up interviews and were prescribed antiretroviral therapy at the second follow-up interview (54% white, 28% black, 14% Hispanic, and 3% others). Results: Minorities were less likely to report perfect adherence than whites (40% vs. 50%, P # 0.001). Over one third (40%) of all participants reporting ever having discriminatory health care experiences since having HIV, and 24% did not completely or almost completely trust their health care providers. The effect of minority status on adherence persisted in the full model. More discrimination predicted greater distrust, weaker treatment benefit beliefs, and, in turn, poorer adherence. Distrust affected adherence by increasing treatment-related psychological distress and weakening treatment benefit beliefs. Conclusions: The relationship between minority status and adherence was not fully explained by patient-level factors. Future studies should consider conceptualizing minority status as a contextual factor rather than predictor.


Export/Citation:EndNote | BibTeX | Dublin Core | ASCII (Chicago style) | HTML Citation | OpenURL | Reference Manager
Social Networking:

Item Type: Article
Additional Information: Access to full text is subject to the publisher's access restrictions.
Uncontrolled Keywords: antiretroviral therapy; adherence; disparities; race/ethnicity
Subjects: Research
Health > Public Health > Chronic Illness & Diseases
Health > Public Health > Health Risk Factors > Stress
Health > Disparities
Health
Health > Public Health > Health Risk Factors
Research > studies
Research > methodologies
Health > Public Health
Health > Public Health > Chronic Illness & Diseases > HIV/Aids
Health > Health Equity > Access To Healthcare
Health > Health Equity
Related URLs:
    Depositing User: Users 141 not found.
    Date Deposited: 03 Oct 2008
    Last Modified: 29 Apr 2011 13:42
    Link to this item (URI): http://health-equity.pitt.edu/id/eprint/1059

    Actions (login required)

    View Item