Physician Mistrust, Medical System Mistrust, and Perceived Discrimination: Associations with HIV Care Engagement and Viral Load

Ahnalee M. Brincks, Karen Shiu-Yee, Lisa R. Metsch, Carlos del Rio, Robert P. Schwartz, Petra Jacobs, Georgina Osorio, James L. Sorensen, Daniel J Feaster

Research output: Contribution to journalArticle

1 Scopus citations


Medical mistrust is an important risk factor for many health outcomes. For individuals with HIV and substance use co-morbidities, mistrust may influence engagement with health care, and affect overall health and transmission risk. Medical mistrust can be measured by an individual’s mistrust of his/her physician, or mistrust of the medical system. This study examined both types of mistrust among 801 substance-using individuals with uncontrolled HIV infection. The aims were to determine how physician mistrust, medical system mistrust, and discrimination experiences were associated with engagement in HIV primary care. Findings indicated higher levels of physician mistrust, but not medical system mistrust, were associated with a longer time since the last visit to an HIV provider. Longer time since seeing an HIV care provider was associated with higher viral load. This study refines our understanding of the relationship between mistrust and HIV care engagement for a large, diverse sample of substance-using individuals.

Original languageEnglish (US)
JournalAIDS and Behavior
StatePublished - Jan 1 2019



  • Discrimination
  • Health care engagement
  • HIV
  • Medical mistrust

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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