Angela D. Thrasher|Jo Anne Earp|Carol E. Golin|Catherine Zimmer
Discrimination, Distrust, and Racial/Ethnic Disparities in Antiretroviral Therapy Adherence Among a National Sample of HIV-Infected Patients
University of California, San Francisco|University of North Carolina at Chapel Hill
although discriminatory health care experiences health care provider distrust shown associated health care disparities little known contribution racialethnic disparities antiretroviral therapy adherence therefore sought assess extent discriminatory health care experiences health care provider distrust influence treatmentrelated attitudes beliefs selfreported adherence national sample hivinfected patientsthis secondary analysis used data hiv cost services utilization study used structural equation modeling identify pathways minority status adherence discrimination distrust treatmentrelated attitudes beliefsthe sample 1886 participants completed baseline 2 followup interviews prescribed antiretroviral therapy second followup interview 54 white 28 black 14 hispanic 3 othersminorities less likely report perfect adherence whites 40 vs 50 p 0001 one third 40 participants reporting ever discriminatory health care experiences since hiv 24 completely almost completely trust health care providers effect minority status adherence persisted full model discrimination predicted greater distrust weaker treatment benefit beliefs turn poorer adherence distrust affected adherence increasing treatmentrelated psychological distress weakening treatment benefit beliefsthe relationship minority status adherence fully explained patientlevel factors future studies consider conceptualizing minority status contextual factor rather predictor