“I Felt Somewhat Cheated and Deceived When that Roadblock Came”: PrEP-Related Medical Mistrust, Distrust, and Misinformation Among Black Sexual Minority Men

Substantial advances have been made in medical technologies to reduce HIV transmission in previous decades. However, disparities regarding HIV transmission continue to persist, with Black sexual minority men (BSMM) disproportionately impacted. These disparities are driven by several different economic and socio-cultural barriers, some of which include the ongoing mistrust or distrust of medicine and science among communities of color. Furthermore, the spread of misinformation has also substantially hampered the ability to effectively communicate the importance and efficacy of a major tool that can be used to reduce HIV transmission: pre-exposure prophylaxis (PrEP). Therefore, the goal of this study was to provide an understanding of BSMM's experiences with and trust in medicine and practitioners, more broadly. The current study utilized interview data to qualitatively analyze the experiences of 32 BSMM in the United States. A thematic analysis was conducted, and we developed three different overarching themes to categorize different aspects of (a) medical mistrust, (b) medical distrust, and (c) misinformation. Results suggest that mistrust, distrust, and the spread of misinformation pertaining to medical institutions, medications (e.g., PrEP, antiretrovirals), and practitioners are present and appear to influence perceptions of HIV/AIDS and interest, access, or uptake and use of PrEP. Findings can inform ways to effectively rebuild relationships with medical providers and communicate information about PrEP uptake and HIV/AIDS by addressing medical mistrust and misinformation.