Tami Alade, Shawnika Hull, Hannah Sinks, Jennifer Zack, Patricia Moriarty, Rachel K Scott
{"title":"黑人顺性别妇女的医疗不信任与暴露前预防的意向","authors":"Tami Alade, Shawnika Hull, Hannah Sinks, Jennifer Zack, Patricia Moriarty, Rachel K Scott","doi":"10.1089/apc.2025.0043","DOIUrl":null,"url":null,"abstract":"<p><p>Black women bear a disproportionate burden of the US HIV epidemic, compared with women of other racial groups. Pre-exposure prophylaxis (PrEP) is a highly effective prevention tool. Evidence indicates that Black women are interested in initiating PrEP, but low utilization persists in this population. Historical mistreatment of women of color and the resulting distrust erect barriers to communication and shared decision-making with health care providers. Using an institutional review board-approved questionnaire, we surveyed 186 adults (83% Black; 9% White; 3% American Indian/Alaskan Native; 4% Other) who were PrEP eligible, HIV seronegative, cisgender women in Washington, DC. We tested the interaction of patient racial identification and group-based medical mistrust on intentions to use PrEP, as mediated by intentions to discuss PrEP with a health care provider during the imminent clinical interaction. Results indicate significant moderated mediation of the interaction between race and distrust on intention to initiate PrEP at 3 months [index = -0.3093, standard error (SE) = 0.1886, 95% confidence interval (CI; -0.7455, -0.0122)] and 12 months [index = -0.3248, SE = 0.1987, 95% CI: (-0.7827, -0.0040)] through an anticipated discussion with a provider. When distrust is low, Black women had stronger intentions to utilize PrEP (relative to women of other racial groups). This was explained by stronger intentions to discuss PrEP with the provider during the clinical visit. These results underscore the critical importance of provider-initiated discussion of PrEP with women to improve health equity. This study was limited by the low number of non-Black participants (17%) as well as the requirement that subjects be English-speaking only.</p>","PeriodicalId":7476,"journal":{"name":"AIDS patient care and STDs","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Medical Distrust and the Intention to Initiate Pre-Exposure Prophylaxis in Black Cisgender Women.\",\"authors\":\"Tami Alade, Shawnika Hull, Hannah Sinks, Jennifer Zack, Patricia Moriarty, Rachel K Scott\",\"doi\":\"10.1089/apc.2025.0043\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Black women bear a disproportionate burden of the US HIV epidemic, compared with women of other racial groups. Pre-exposure prophylaxis (PrEP) is a highly effective prevention tool. Evidence indicates that Black women are interested in initiating PrEP, but low utilization persists in this population. Historical mistreatment of women of color and the resulting distrust erect barriers to communication and shared decision-making with health care providers. Using an institutional review board-approved questionnaire, we surveyed 186 adults (83% Black; 9% White; 3% American Indian/Alaskan Native; 4% Other) who were PrEP eligible, HIV seronegative, cisgender women in Washington, DC. We tested the interaction of patient racial identification and group-based medical mistrust on intentions to use PrEP, as mediated by intentions to discuss PrEP with a health care provider during the imminent clinical interaction. Results indicate significant moderated mediation of the interaction between race and distrust on intention to initiate PrEP at 3 months [index = -0.3093, standard error (SE) = 0.1886, 95% confidence interval (CI; -0.7455, -0.0122)] and 12 months [index = -0.3248, SE = 0.1987, 95% CI: (-0.7827, -0.0040)] through an anticipated discussion with a provider. When distrust is low, Black women had stronger intentions to utilize PrEP (relative to women of other racial groups). This was explained by stronger intentions to discuss PrEP with the provider during the clinical visit. These results underscore the critical importance of provider-initiated discussion of PrEP with women to improve health equity. This study was limited by the low number of non-Black participants (17%) as well as the requirement that subjects be English-speaking only.</p>\",\"PeriodicalId\":7476,\"journal\":{\"name\":\"AIDS patient care and STDs\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-06-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AIDS patient care and STDs\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/apc.2025.0043\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS patient care and STDs","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/apc.2025.0043","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Medical Distrust and the Intention to Initiate Pre-Exposure Prophylaxis in Black Cisgender Women.
Black women bear a disproportionate burden of the US HIV epidemic, compared with women of other racial groups. Pre-exposure prophylaxis (PrEP) is a highly effective prevention tool. Evidence indicates that Black women are interested in initiating PrEP, but low utilization persists in this population. Historical mistreatment of women of color and the resulting distrust erect barriers to communication and shared decision-making with health care providers. Using an institutional review board-approved questionnaire, we surveyed 186 adults (83% Black; 9% White; 3% American Indian/Alaskan Native; 4% Other) who were PrEP eligible, HIV seronegative, cisgender women in Washington, DC. We tested the interaction of patient racial identification and group-based medical mistrust on intentions to use PrEP, as mediated by intentions to discuss PrEP with a health care provider during the imminent clinical interaction. Results indicate significant moderated mediation of the interaction between race and distrust on intention to initiate PrEP at 3 months [index = -0.3093, standard error (SE) = 0.1886, 95% confidence interval (CI; -0.7455, -0.0122)] and 12 months [index = -0.3248, SE = 0.1987, 95% CI: (-0.7827, -0.0040)] through an anticipated discussion with a provider. When distrust is low, Black women had stronger intentions to utilize PrEP (relative to women of other racial groups). This was explained by stronger intentions to discuss PrEP with the provider during the clinical visit. These results underscore the critical importance of provider-initiated discussion of PrEP with women to improve health equity. This study was limited by the low number of non-Black participants (17%) as well as the requirement that subjects be English-speaking only.
期刊介绍:
AIDS Patient Care and STDs is the foremost journal providing the latest developments and research in diagnostics and therapeutics designed to prolong the lifespan and improve quality of life for HIV/AIDS patients. The Journal delivers cutting-edge clinical, basic science, sociologic, and behavior-based investigations in HIV/AIDS and other sexually transmitted infections. Clinical trials, quantitative and qualitative analyses of pilot studies, comprehensive reviews, and case reports are presented from leading experts and scientists around the world.
AIDS Patient Care and STDs coverage includes:
Prominent AIDS medications, therapies, and antiretroviral agents
HIV/AIDS-related diseases, infections, and complications
Challenges of medication adherence
Current prevention techniques for HIV
The latest news and developments on other STDs
Treatment/prevention options, including pre- and post-exposure prophylaxis