by Jeffrey T. Kirchner, DO, AAHIVS, AAHIVM Chief Medical Officer

December 8, 2020

Featured Literature:

Bogart LM et al. COVID-19 Related Medical Mistrust, Health Impacts, and Potential Vaccine Hesitancy Among Black Americans Living with HIV. J Acquir Immune Defic Syndr. November 9, 2020. Epub ahead of print. PMID: 33196555. doi: 10.1097/QAI.0000000000002570

Systemic racism has led to medical mistrust among Black Americans and likely plays a role with inequalities seen during the current COVID-19 pandemic. This study from Los Angeles included 101 Black Americans living with HIV. Their mean age was 50.3 years and 86% were male. These individuals were part of an ongoing trial of community-based adherence to ART. The study’s aim was to examine the association of COVID-19 related medical mistrust (e.g., government not disclosing information), with COVID-19 vaccine and COVID-19 treatment hesitancy. The study also assessed any negative effect of COVID-19 on adherence to ART. From May to July 2020, subjects completed phone interviews regarding negative COVID-19 impacts, general COVID-19 mistrust, vaccine hesitancy, and lack of trust in COVID-19 information sources. Adherence to ART was monitored electronically with the medication event monitoring system. Nearly all participants (97%) endorsed at least one general COVID-19 mistrust belief. More than 50% had at least one COVID-19 vaccine or treatment hesitancy belief. Greater COVID-19 mistrust was significantly associated with reluctance to accept a vaccine when it becomes available. Subjects who experienced more negative COVID-19 impacts had lower ART adherence. Healthcare providers and social service workers were reported to be the most trusted sources of medical information.

Author’s Commentary:

The results of this study are not surprising but nonetheless discouraging. At the time of this writing the U.S. COVID-19 pandemic continues to escalate. Moreover, recent data has found that PWH have worse clinical outcomes compared to HIV-negative persons infected with the SARS Coronavirus-2. We have learned a great deal about this coronavirus since the pandemic starting but new information from the scientific and medical communities is being released at a rapid pace. With the prospects of a COVID-19 vaccine in the weeks and months ahead, it is important for healthcare providers to engage with patients as well as communities to provide accurate and reassuring information regarding aspects of the COVID-19 pandemic.

The author has no conflicts of interest to disclose.

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