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HIV-Related Mistrust (or HIV Conspiracy Theories) and Willingness to Use PrEP Among Black Women in the United States

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Abstract

Uptake of pre-exposure prophylaxis (PrEP) among Black women living in the US is suboptimal. We sought to determine the association between HIV-related medical mistrust (or belief in HIV conspiracy theories) and willingness to use PrEP among Black women. We analyzed data from the 2016 National Survey on HIV in the Black Community (NSHBC), a nationally representative cross-sectional survey. Among NSHBC participants, 522 were women and 347 (69.0%) reported HIV risk factors. Only 14.1% were aware that PrEP exists; 30.8% reported willingness to use PrEP. HIV-related medical mistrust was reported by 60.4% of women. In multivariable analysis, controlling for income, education, marital status and health care engagement, belief in conspiracy theories was significantly associated with higher willingness to use PrEP. The HIV-Related Medical Mistrust Scale item: “there is a cure for HIV, but the government is withholding it from the poor” was independently associated with higher PrEP willingness. This finding speaks to the need for an improved understanding of the role of HIV-related medical mistrust among Black women to improve uptake of biomedical HIV prevention.

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Funding

This publication was made possible through funding from K23 MH107316 (BOO), the Harvard University Center for AIDS Research (CFAR), an NIH funded program (P30 AI060354) to support the effort of BOO and KHM, CHIPTS: P30MH058107 to support the work of LMB, and the National Institute of General Medical (NIGMS) Interdisciplinary Training Grant for Biostatisticians (T32 GM74905) who supported the effort of TFM.

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Authors and Affiliations

  1. Division of Global Health Equity, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    B. O. Ojikutu

  2. Harvard School of Medicine, Boston, MA, USA

    B. O. Ojikutu

  3. Tufts University School of Medicine, Boston, MA, USA

    N. Amutah-Onukagha & C. Tibbitt

  4. School of Public Health, Boston University, Boston, MA, USA

    T. F. Mahoney

  5. University of Miami Medical Center, Miami, FL, USA

    S. D. Dale

  6. The Fenway Institute, Boston, MA, USA

    K. H. Mayer

  7. Beth Israel Lahey Medical Center, Boston, MA, USA

    K. H. Mayer

  8. RAND Corporation, Santa Monica, CA, USA

    L. M. Bogart

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  1. B. O. Ojikutu
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Correspondence to B. O. Ojikutu.

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KHM reports receiving grants from Gilead Pharmaceuticals and from ViiV Healthcare.

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Ojikutu, B.O., Amutah-Onukagha, N., Mahoney, T.F. et al. HIV-Related Mistrust (or HIV Conspiracy Theories) and Willingness to Use PrEP Among Black Women in the United States. AIDS Behav 24, 2927–2934 (2020). https://doi.org/10.1007/s10461-020-02843-z

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