HIV Testing Barriers Among Black and Latina Women: An Examination of Medical Mistrust, Daily Discrimination, and...

Background: Black and Latina women are disproportionally affected by Human Immunodeficiency Virus (HIV) and medical mistrust may be a testing barrier, especially among women experiencing substance use and discrimination. Objectives: This study examined current substance use, daily discrimination exposure, and medical mistrust factors (medical disparities, medical suspiciousness) on HIV testing. An online survey was completed by 97 Black and/or Latina women. Bayesian generalized linear modeling tested two hypotheses: 1) Current substance use, higher discrimination exposure, and higher medical mistrust would reduce the odds of HIV testing (ever being tested and recent testing within the past year), 2) Substance use and discrimination would moderate associations between medical mistrust and testing. Results: For Hypothesis 1, current substance use (Odds Ratio [OR]=1.42), higher discrimination exposure (OR=1.26), lower medical disparities (OR=0.83), and lower medical suspiciousness (OR=0.70) were associated with higher odds of ever being HIV tested. For Hypothesis 2, current substance use moderated the association between medical disparities with ever being HIV testing, while discrimination exposure moderated the association between medical suspiciousness with ever being tested (ORs<0.66). Current substance use moderated the associations between medical disparities and medical suspiciousness with recent HIV testing, while discrimination exposure also moderated the association between medical suspiciousness with recent testing (ORs>1.11). Conclusions: HIV testing barriers were generally associated with higher odds of testing, suggesting complex relationships may occur within medical settings for high-risk women experiencing discrimination.