HIV/AIDS-related institutional mistrust among multiethnic men who have sex with men: effects on HIV testing and risk behaviors.
Abstract
OBJECTIVE: To investigate relationships between institutional mistrust (systematic
discrimination, organizational suspicion, and conspiracy beliefs), HIV risk behaviors,
and HIV testing in a multiethnic sample of men who have sex with men (MSM), and to
test whether perceived susceptibility to HIV mediates these relationships for White
and ethnic minority MSM. METHOD: Participants were 394 MSM residing in Central Arizona
(M age = 37 years). Three dimensions of mistrust were examined, including organizational
suspicion, conspiracy beliefs, and systematic discrimination. Assessments of sexual
risk behavior, HIV testing, and perceived susceptibility to HIV were made at study
entry (T1) and again 6 months later (T2). RESULTS: There were no main effects of institutional
mistrust dimensions or ethnic minority status on T2 risk behavior, but the interaction
of systematic discrimination and conspiracy beliefs with minority status was significant
such that higher levels of systematic discrimination and more conspiracy beliefs were
associated with increased risk only among ethnic minority MSM. Higher levels of systematic
discrimination were significantly related to lower likelihood for HIV testing, and
the interaction of organizational suspicion with minority status was significant such
that greater levels of organizational suspicion were related to less likelihood of
having been tested for HIV among ethnic minority MSM. Perceived susceptibility did
not mediate these relationships. CONCLUSION: Findings suggest that it is important
to look further into the differential effects of institutional mistrust across marginalized
groups, including sexual and ethnic minorities. Aspects of mistrust should be addressed
in HIV prevention and counseling efforts.
Type
Journal articleSubject
AdultArizona
Attitude to Health
Coitus
Delivery of Health Care
Ethnic Groups
HIV Infections
HIV Seropositivity
Homosexuality, Male
Humans
Institutional Practice
Male
Minority Groups
Patient Compliance
Prejudice
Risk
Risk-Taking
Sexual Behavior
Trust
Unsafe Sex
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https://hdl.handle.net/10161/6214Published Version (Please cite this version)
10.1037/a0025953Publication Info
Hoyt, Michael A; Rubin, Lisa R; Nemeroff, Carol J; Lee, Joyce; Huebner, David M; &
Proeschold-Bell, Rae Jean (2012). HIV/AIDS-related institutional mistrust among multiethnic men who have sex with men:
effects on HIV testing and risk behaviors. Health Psychol, 31(3). pp. 269-277. 10.1037/a0025953. Retrieved from https://hdl.handle.net/10161/6214.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Rae Jean Proeschold-Bell
Research Professor of Global Health
Rae Jean Proeschold-Bell is interested in the interplay between mental and physical
well-being and has designed and tested interventions that integrate care for people
with obesity and depression; HIV/AIDS and substance use; and hepatitis C and alcohol
use. Most recently, Rae Jean has been studying positive mental health as a way to
prevent depression and promote caring for one's physical health. Her work currently
focuses on caregivers, including clergy in North Carolina and ca

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