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Cited by 21HIV/AIDS Research and InterventionsGender, Health, and Social InequalityRacial and Ethnic Identity Research

Perceptions of healthcare accessibility and medical mistrust among Black women living with HIV in the USA

Open access
Small, Latoya A., Godoy, Sarah M., Lau, Caitlin·2023·Culture, Health & Sexuality
DOI 10.1080/13691058.2022.2155706PMC PMC10558086
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Abstract

Black women living with HIV in the USA frequently endure structural racism, racial biases and discrimination in healthcare that affect their access to care. To explore their experiences in healthcare settings as they relate to HIV-treatment accessibility and medical mistrust we used intersectionality and structural intersectionality as guiding frameworks. Four focus groups were conducted with 20 low-income Black women living with HIV in a large urban region. Using thematic analysis, we identified four themes: (1) multilevel stigma and discrimination; (2) medical mistrust of providers across multiple settings; (3) varying responses to stigma, discrimination, and medical mistrust; and (4) preferences for patient-provider relationships. Participants described how medical providers, nurses and other healthcare staff perpetuated negative treatment, including multiple forms of discrimination and stigmatisation based on their HIV diagnosis, race, class and gender. The stigma, discrimination and resulting mistrust experienced often caused hurt feelings and decisions to disengage from treatment or remain with providers while feeling unwelcome. Participants described the strong desire to feel seen, supported and validated by healthcare providers. Narratives reveal that feelings of being discriminated against can cultivate mistrust not only towards doctors, but other provider types and settings. Findings can inform care models for low-income Black women living with HIV.

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  • In the review, the operationalization of structural racism that most closely aligned with its structural-level conceptualization was the use of the State Racism Index by two studies.

    “In our review, the operationalization of structural racism that most closely aligned with its conceptualization at the structural level was the use of the SRI by two of the studies [21,22].”

    From Structural Racism Conceptualization and Operationalization for Research for the U.S. HIV Epidemic: Findings from a Scoping Review and Implications for Advancing Research for Structural Interventions (2024) · cites this paper as [22]

    The Materials and methods sections describe focus groups and thematic analysis, not use of a State Racism Index. A search of our full-text copy for “State Racism Index,” “SRI,” and structural-racism measurement found no passage establishing that this was one of the two studies identified in the citing review. (LLM, conf=0.76)

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Authors
Small, L. A., Godoy, S. M., & Lau, C.
Affiliations
  • University of California, Los Angeles (US)
  • University of North Carolina at Chapel Hill (US)
Corresponding author
Small, Latoya A.
ORCID
Venue
Culture, Health & Sexuality
Publisher
Informa UK Limited
Published
2022-12-26
Volume
25
Issue
10
Pages
1295-1309
ISSN
  • 1369-1058 (ISSN-L)
  • 1464-5351
DOI
10.1080/13691058.2022.2155706
PMC
PMC10558086
OpenAlex
W4312194503
Cited by
21
References
3
Citations by year
2026: 5 · 2025: 8 · 2024: 6 · 2023: 2
FWCI
1.96
Type
journal article
Language
en
Open access
Locations
  • Culture Health & Sexuality (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
  • UNC Libraries
Funders
  • the UCLA Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) via a Mentored Pilot
  • UCLA Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) Mentored Pilot Grant
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Social Sciences › Sociology and Political Science › Gender, Health, and Social Inequality
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
Keywords
Black women, HIV, health care access, medical mistrust, structural racism, racism in healthcare, stigma, intersectionality, structural intersectionality, patient-provider relationship, low-income women, HIV treatment engagement, gender discrimination
MeSH terms
Black or African American, Delivery of Health Care, Female, Health Services Accessibility, Humans, HIV Infections, Trust, Social Stigma, Racism

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