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Soc Work Res. 2013 Sep 1;37(3):219-226.

Race, Relationships and Trust in Providers among Black Patients with HIV/AIDS.

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Graduate School of Social Work, Boston College, Boston, MA.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Division of General Internal Medicine & Geriatrics, Oregon Health & Science University, Portland.
Center for Comprehensive Care, St. Luke's-Roosevelt Hospital Center, New York, NY.
Division of Infectious Diseases, Department of Medicine, Wayne State University School of Medicine, Detroit, MI.
Division of General Internal Medicine & Geriatrics, Oregon Health & Science University, Portland ; Section of General Internal Medicine, Portland VA Medical Center, Portland.


A trustful patient-provider relationship is a strong predictor of positive outcomes, including treatment adherence and viral suppression, among patients with HIV/AIDS. Understanding factors that inform this relationship is especially relevant for Black patients, who bear a disproportionate burden of HIV morbidity and mortality, and may face challenges associated with seeing providers of a racial/ethnic background that is different from their own. Using data collected through the Enhancing Communication and HIV Outcomes (ECHO) study, we build upon extant research by examining patient and provider characteristics that may influence Black patients' trust in their provider. ECHO data were collected from four ambulatory care sites in Baltimore, Detroit, New York and Portland, Oregon (N=435). Regression analysis results indicate that trust in health care institutions and cultural similarity between patient and provider are strongly associated with patients' trust in their provider. Lower perceived social status, being currently employed, and having an older provider were also related to greater patient-provide trust. These findings can inform interventions to improve trust and reduce disparities in HIV care and outcomes that stem from mistrust among Black patients.


Blacks; HIV/AIDS; culture; physician-patient relations; trust

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