Trust, conspiracy beliefs, and the use of HAART
by Boore, Amy L., Ph.D., THE JOHNS HOPKINS UNIVERSITY, 2007, 172 pages; 3288434

Abstract:

Background. Endorsement of HIV/AIDS conspiracy beliefs may play an important role in treatment decisions of patients. This study sought to describe the prevalence of and factors associated with HIV/AIDS conspiracy beliefs, as well as the association between such beliefs and HAART usage patterns, among women enrolled in the Women's Interagency HIV Study (WIHS).

Methods. 436 WIHS participants responded to the statement “there is a cure for HIV, but the government wants to keep it from certain people” between 1996-2000. GEE logistic regression was used to explore the association of agreement with this statement to subsequent switching, downshifting, or discontinuation of HAART. In 2006, 1,570 WIHS participants completed a “trust” questionnaire that included an HIV/AIDS Conspiracy Belief Scale. Multivariate logistic regression was used to describe the associations between this scale and the use of HAART among women medically eligible for HAART. Other outcomes explored in this analysis included virologic response following HAART use and adherence to HAART. The prevalence and correlates of “distrust” were described for all groups of women at both time periods used in the study.

Results. Overall, 25% of 1,570 women agreed, on average, with 6 conspiracy belief statements. Women who endorsed conspiracy beliefs did so despite frequently having a high amount of trust in their personal provider and having access to information and education about HIV through the study. Race was found to be associated with endorsement of conspiracy beliefs, with non-Hispanic black women being more likely to hold the beliefs than Hispanic or non-Hispanic white women. Other associated factors varied between the racial groups. There was no significant different between HIV positive and HIV negative women in endorsement of conspiracy beliefs. Endorsement of HIV/AIDS conspiracy beliefs was associated with nonuse of HAART among medically eligible women (OR=2.0, p=.02) and with more frequent discontinuation of HAART (OR=1.4, p=.05), but not with switching therapy (OR=1.3, p=.12), downshifting therapy (OR=1.1, p=.69), adhering to therapy (OR=1.2, p=.41), or with virologic outcomes following HAART use (OR=.90, p=.70).

Conclusions. Belief in HIV/AIDS conspiracy theories was common and appeared to present a barrier to women accepting or maintaining HAART.

 
AdviserStephen J. Gange
SchoolTHE JOHNS HOPKINS UNIVERSITY
SourceDAI/B 68-11, p. , Mar 2008
Source TypeDissertation
SubjectsPublic health; Epidemiology
Publication Number3288434
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