COVID-19 Related Medical Mistrust, Health Impacts, and Potential Vaccine Hesitancy Among Black Americans Living With HIV. Bogart, L. M., Ojikutu, B. O., Tyagi, K., Klein, D. J., Mutchler, M. G., Dong, L., Lawrence, S. J., Thomas, D. R., & Kellman, S. Journal of Acquired Immune Deficiency Syndromes (1999), 86(2):200–207, February, 2021. 00003
doi  abstract   bibtex   
BACKGROUND: Medical mistrust, a result of systemic racism, is prevalent among Black Americans and may play a role in COVID-19 inequities. In a convenience sample of HIV-positive Black Americans, we examined associations of COVID-19-related medical mistrust with COVID-19 vaccine and COVID-19 treatment hesitancy and negative impacts of COVID-19 on antiretroviral therapy (ART) adherence. METHODS: Participants were 101 HIV-positive Black Americans (age: M = 50.3 years; SD = 11.5; 86% cisgender men; 77% sexual minority) enrolled in a randomized controlled trial of a community-based ART adherence intervention in Los Angeles County, CA. From May to July 2020, participants completed telephone interviews on negative COVID-19 impacts, general COVID-19 mistrust (eg, about the government withholding information), COVID-19 vaccine and treatment hesitancy, and trust in COVID-19 information sources. Adherence was monitored electronically with the Medication Event Monitoring System. RESULTS: Nearly all participants (97%) endorsed at least one general COVID-19 mistrust belief, and more than half endorsed at least one COVID-19 vaccine or treatment hesitancy belief. Social service and health care providers were the most trusted sources. Greater COVID-19 mistrust was related to greater vaccine and treatment hesitancy [b (SE) = 0.85 (0.14), P \textless 0.0001 and b (SE) = 0.88 (0.14), P \textless 0.0001, respectively]. Participants experiencing more negative COVID-19 impacts showed lower ART adherence, assessed among a subset of 49 participants [b (SE) = -5.19 (2.08), P = 0.02]. DISCUSSION: To prevent widening health inequities, health care providers should engage with communities to tailor strategies to overcome mistrust and deliver evidence-based information, to encourage COVID-19 vaccine and treatment uptake.
@article{bogart_covid-19_2021,
	title = {{COVID}-19 {Related} {Medical} {Mistrust}, {Health} {Impacts}, and {Potential} {Vaccine} {Hesitancy} {Among} {Black} {Americans} {Living} {With} {HIV}},
	volume = {86},
	issn = {1944-7884},
	doi = {10/ghtrch},
	abstract = {BACKGROUND: Medical mistrust, a result of systemic racism, is prevalent among Black Americans and may play a role in COVID-19 inequities. In a convenience sample of HIV-positive Black Americans, we examined associations of COVID-19-related medical mistrust with COVID-19 vaccine and COVID-19 treatment hesitancy and negative impacts of COVID-19 on antiretroviral therapy (ART) adherence.
METHODS: Participants were 101 HIV-positive Black Americans (age: M = 50.3 years; SD = 11.5; 86\% cisgender men; 77\% sexual minority) enrolled in a randomized controlled trial of a community-based ART adherence intervention in Los Angeles County, CA. From May to July 2020, participants completed telephone interviews on negative COVID-19 impacts, general COVID-19 mistrust (eg, about the government withholding information), COVID-19 vaccine and treatment hesitancy, and trust in COVID-19 information sources. Adherence was monitored electronically with the Medication Event Monitoring System.
RESULTS: Nearly all participants (97\%) endorsed at least one general COVID-19 mistrust belief, and more than half endorsed at least one COVID-19 vaccine or treatment hesitancy belief. Social service and health care providers were the most trusted sources. Greater COVID-19 mistrust was related to greater vaccine and treatment hesitancy [b (SE) = 0.85 (0.14), P {\textless} 0.0001 and b (SE) = 0.88 (0.14), P {\textless} 0.0001, respectively]. Participants experiencing more negative COVID-19 impacts showed lower ART adherence, assessed among a subset of 49 participants [b (SE) = -5.19 (2.08), P = 0.02].
DISCUSSION: To prevent widening health inequities, health care providers should engage with communities to tailor strategies to overcome mistrust and deliver evidence-based information, to encourage COVID-19 vaccine and treatment uptake.},
	language = {eng},
	number = {2},
	journal = {Journal of Acquired Immune Deficiency Syndromes (1999)},
	author = {Bogart, Laura M. and Ojikutu, Bisola O. and Tyagi, Keshav and Klein, David J. and Mutchler, Matt G. and Dong, Lu and Lawrence, Sean J. and Thomas, Damone R. and Kellman, Sarah},
	month = feb,
	year = {2021},
	pmid = {33196555},
	note = {00003 },
	keywords = {Female, Humans, Male, Adult, Middle Aged, Trust, Los Angeles, Health Knowledge, Attitudes, Practice, Medication Adherence, African Americans, COVID-19, SARS-CoV-2, HIV Infections, COVID-19 Vaccines, Anti-Retroviral Agents, Sexual and Gender Minorities},
	pages = {200--207},
	annote = {Primary Question: in a convenience sample of Black Americans living with HIV, we examined levels of general COVID-19 mistrust related to COVID-19 and assessed associations between general COVID-19 mistrust and COVID-19 treatment and future vaccine hesitancy,
Hypothesis: greater mistrust would be associated with greater hesitancy. We also hypothesized that negative COVID-19-related impacts would be associated with lower antiretroviral therapy (ART) adherence.
Participants: 103 participants were reached during the time frame (May-July, 2020), and 101 participants completed the 15-20 minutes COVID-19 telephone interview; 33 participants could not be contacted after multiple attempts and 2 participants declined
Outcome variables: General covid-19 mistrust: 10-item tool (mistrust in PH, withholding cure, etc); vaccine and treatment hesitancy (would not want to get it, would not trust it, etc); trust in information sources (HC providers, fed gov't); ART adherence (Medication Event Monitoring System: measured doses taken)
Results: high levels of general COVID-19 mistrust and high levels of hesitancy related to treatment and a future vaccine (Table 2). Nearly all (97\%) endorsed at least one mistrust belief. The most prevalent general mistrust beliefs (endorsed by about half or more than half) concerned withholding information or a lack of honesty by the government. More than half of participants showed hesitancy regarding a COVID-19 future vaccine or treatment across the items, with about a third saying they would not get vaccinated or treated
greater trust in HC providers than the government (a fifth said black people cannot trust providers); least trusted was federal government, including the US president, followed by social media
less than a HS education showed higher levels of covid-19 mistrust, vaccine hesitancy and treatment hesitancy
Greater mistrust associated with greater vaccine heistancy and Tx hesitancy
conclusion: To prevent widening health inequities, health care providers should engage with communities to tailor strategies to overcome mistrust and deliver evidence-based information, to encourage COVID-19 vaccine and treatment uptake.},
	file = {Bogart et al. - 2020 - COVID-19 Related Medical Mistrust, Health Impacts,.pdf:C\:\\Zotero\\storage\\53QX45HZ\\Bogart et al. - 2020 - COVID-19 Related Medical Mistrust, Health Impacts,.pdf:application/pdf}
}

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