| Poster | Poster Session 09 Program Schedule
02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)
Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease
Final Abstract #48
Healthcare Inequities and Systemic Barriers: Examining Medical Trust Among Black/African American Adults with HIV
Jasia-Jemay Henderson-Murphy, California State University- Northridge, Northridge, United States
Jeremy Grant, University of Florida, Gainesville, United States
Alyssa Arentoft, California State University, Northridge, Northridge, United States
Category: Infectious Disease (HIV/COVID/Hepatitis/Viruses)
Keyword 1: HIV/AIDS
Keyword 2: quality of life
Keyword 3: self-report
Objective:
Discrimination and healthcare inequities in the U.S. have contributed to negative experiences and perceptions of healthcare institutions within the Black community. These circumstances create barriers to quality treatment and negatively impact health outcomes. Research has shown that higher levels of medical mistrust are associated with adverse HIV health outcomes, such as lower medication adherence and higher HIV viral load. We sought to identify items embedded in a self-reported healthcare quality measure that reflect levels of medical mistrust, and to explore their relationship with key health-related outcomes, including neuropsychological and functional performance, quality of life, and overall psychosocial functioning among Black adults with HIV.
Participants and Methods:
71 Black adults with HIV in the Los Angeles area (age = 52.41 ± 9.83, education = 12.93 ± 1.65; 84% cisgender men, 12% cisgender women, 1% transgender men, 3% transgender women) completed the QUOTE-HIV, a measure of perceived healthcare quality, in addition to comprehensive neuropsychological (NP) and functional assessments, psychiatric and sociodemographic interviews, and self-report psychosocial and sociocultural questionnaires. One author [J.H.M.] identified existing measures of medical mistrust, and three authors [J.H.M., J.G., A.A.] independently evaluated and matched candidate items from the QUOTE-HIV scale. Items for which consensus was obtained were retained and summed, comprising our medical trust subscale.
Results:
Among Black participants, better everyday functioning was significantly associated with higher levels of medical trust (rs = -.30, p <.01) but not with reported healthcare quality (rs = -.18, p = .12); neither medical trust nor healthcare quality were associated with neuropsychological domain T-scores (all ps > .05). However, less self-reported cognitive failures were associated with more medical trust (rs = -.39, p <.01) and higher healthcare quality (rs = -.40, p <.01). Higher self-efficacy was associated with more medical trust (rs = .44, p <.01) and higher healthcare quality (rs = .34, p <.01). Higher levels of medical trust and better healthcare quality were also associated with greater social support (i.e., MOS-SSS total and all subscales scores; all ps < .05). Finally, both medical trust and healthcare quality were positively associated with better quality of life (i.e., WHO-QOL) on all four domains (all ps < .01).
Conclusions:
Higher medical trust among Black individuals living with HIV was associated with better everyday functioning, quality of life, and social support. Our results suggest that systemic problems resulting in lower medical trust likely contribute to health inequities. To better characterize patients' experiences within the healthcare system, comprehensive healthcare quality measures should also consider cultural factors. This initial investigation may inform future research in this area, including the development of more updated, valid, and reliable measures of medical mistrust tailored for diverse populations, including those living with chronic conditions such as HIV.
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