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APHA Scientific Session and Event Listing

Recorded presentation

Amy L. Boore, MPH¹, Elizabeth T. Golub, PhD¹, Chinazo Cunningham, MD², Tracey Wilson, PhD³, and Stephen J. Gange, PhD¹. (1) Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Box 1134, Baltimore, MD 21205, 443-527-7579, aboore@jhsph.edu, (2) Albert Einstein College of Medicine, Montefiore Medical Center, 111 E. 210th Street, Bronx, NY 10467, (3) Preventive Medicine and Community Health, SUNY Downstate Medical Center, Box 1240, 450 Clarkson Avenue, Brooklyn, NY, NY 11203

Background: Trust in the medical system may play an important role in treatment decisions and outcomes of patients. We sought to explore factors associated with one aspect of trust among HIV+ women enrolled between 1993-1994 in the WIHS. Methods: Between 1996 and 2000, a subset of 413 participants answered a supplemental interview-administered survey up to 8 times over 9 semi-annual visits. The survey included a question on whether or not they believed a cure for HIV exists but is being kept from certain people by the government. GEE analysis was used to look for factors associated with this belief. Results: The 413 HIV+ respondents contributed 1498 person-visits to the analysis. Median current (nadir) CD4 cell count was 199 (98), and most visits (82%) occurred after women reported initiating HAART. 161 women (37%) agreed and 104 (24%) strongly agreed on at least one occasion that a cure for HIV exists but is being withheld. In multivariate GEE analysis, African-American race (p<.01), lower levels of education (p<.01) and income (p=.01), depression (CESD≥16, p=.02), having an unknown exposure risk for HIV (p=.03), and no reported use of combination ARV (p<.01) were all significantly related to expressing this belief after adjusting for age, CD4 cell count, and contact with a healthcare provider. Conclusions: Belief that a cure for HIV exists but is being kept from certain people was common among women, despite being enrolled for between 2-6 years in an HIV research study and having received HIV counseling through the study.

Learning Objectives:

• To discuss trust in the medical system as it relates to HIV care
• To describe characteristics that may be related to distrustful beliefs among HIV+ women

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation