Date of Award

January 2020

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Danya Keene

Second Advisor

Linda Niccolai

Abstract

Objective: To understand how medical mistrust impacts perceptions of PrEP and willingness to use PrEP for African American and Hispanic men and women in New Haven, Connecticut.

Methods: This qualitative study utilized semi-structured interviews to examine medical mistrust, PrEP awareness, and willingness to use PrEP amongst African American and Hispanic men and women in New Haven, Connecticut.

Results: The majority of participants did not know about PrEP before their first interview of this study and the majority of participants did not decide to use PrEP over the course of this study. For those who are not interested in using PrEP, 3 common concerns accompanied their unwillingness to use PrEP, including: 1) concerns about PrEP as a medication, 2) need for improved provider care and knowledge; and 3) perceptions of patient prioritization based on past experiences. For those who did choose to use PrEP or who had partners who chose to use PrEP during the course of the study, perceived risk of HIV and a source of education about the benefit of PrEP outside of the medical establishment were common denominators. Discussions of perceptions of PrEP and participant willingness to use PrEP revealed how medical mistrust impacts perceptions of PrEP and willingness to engage with what is seen as an unnecessary preventative medication.

Implications: Medical mistrust impacts perceptions of PrEP and willingness to engage in HIV preventative measures such as PrEP. As a result, medical mistrust is a significant barrier to willingness to engage in HIV prevention measures using PrEP because it is not trusted. For those that do choose to utilize PrEP or have a partner that does, it is clear that sources of information alternative to traditional healthcare venues can educate about PrEP in a relatable and trustworthy way. Additionally, it is clear that provider education about PrEP is necessary for those patients that do choose to interact with medical systems to obtain PrEP, despite their mistrust.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 05/27/2022

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