"A Gay Man and a Doctor are Just like, a Recipe for Destruction": How Racism and Homonegativity in Healthcare Settings Influence PrEP Uptake Among Young Black MSM. AIDS Behav 2019 Jul;23(7):1951-1963
Date
12/20/2018Pubmed ID
30565092Pubmed Central ID
PMC6571052DOI
10.1007/s10461-018-2375-zScopus ID
2-s2.0-85064462121 (requires institutional sign-in at Scopus site) 158 CitationsAbstract
Young, Black, gay bisexual or other MSM are significantly less likely to use PrEP than their White counterparts. These disparities may be due, in part, to medical mistrust and mistreatment within the healthcare system. This study aimed to uncover how young Black MSM's perceptions of, and experiences with, health care contribute to low engagement in the healthcare system and low PrEP utilization. In late 2017 and early 2018, we conducted six focus groups with 44 Black MSM ages 16-25 in Milwaukee. Focus group topics included participants' knowledge and perceptions of PrEP, perceptions and stereotypes about PrEP users, and general healthcare utilization patterns and behaviors. Focus group transcripts were transcribed verbatim and coded using MAXQDA qualitative analysis software. We used a team-based approach to thematic content analysis to understand how racism and homonegativity affected healthcare access and experiences. Results from this study help to characterize what contributes to mistrust of the healthcare system and healthcare providers to negatively affect PrEP use among young Black MSM. Focus group discussions revealed how previous and anticipated negative interactions with physicians and skepticism about the healthcare system have alienated young Black MSM from the health care system and created significant barriers to PrEP. Efforts to increase PrEP uptake and must address negative and discriminatory interactions with providers and the healthcare system.
Author List
Quinn K, Dickson-Gomez J, Zarwell M, Pearson B, Lewis MAuthors
Julia Dickson-Gomez PhD Professor in the Institute for Health and Equity department at Medical College of WisconsinKatherine Quinn PhD Associate Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Bisexuality
Focus Groups
HIV Infections
Health Services Accessibility
Homophobia
Homosexuality, Male
Humans
Male
Patient Acceptance of Health Care
Physician-Patient Relations
Pre-Exposure Prophylaxis
Qualitative Research
Racism
Sexual and Gender Minorities
Trust
Young Adult
