AIDS and Behavior

, Volume 23, Issue 7, pp 1737–1748 | Cite as

Differences in Medical Mistrust Between Black and White Women: Implications for Patient–Provider Communication About PrEP

  • Mehrit TekesteEmail author
  • Shawnika Hull
  • John F. Dovidio
  • Cara B. Safon
  • Oni Blackstock
  • Tamara Taggart
  • Trace S. Kershaw
  • Clair Kaplan
  • Abigail Caldwell
  • Susan B. Lane
  • Sarah K. Calabrese
Original Paper


Pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention method. PrEP uptake has been persistently low among US women, particularly Black women, who account for 61% of new HIV diagnoses among women. Further understanding of barriers to Black women accessing PrEP is needed. This 2017 cross-sectional survey study explored race-based differences in PrEP interest and intention among women and the indirect association between race and comfort discussing PrEP with a healthcare provider through medical mistrust. The sample consisted of 501 adult women (241 Black; 260 White) who were HIV-negative, PrEP-inexperienced, and heterosexually active. Black women reported greater PrEP interest and intention than White women. However, Black women expressed higher levels of medical mistrust, which, in turn, was associated with lower comfort discussing PrEP with a provider. Medical mistrust may operate as a unique barrier to PrEP access among Black women who are interested in and could benefit from PrEP.


Black/African American Women Pre-exposure prophylaxis (PrEP) Medical mistrust HIV/AIDS 



The authors are grateful to all individuals who participated in the present study. This study was funded by Yale Center for Interdisciplinary Research on AIDS (CIRA), which is funded by the National Institute of Mental Health under Award Number P30-MH062294. The efforts of S. K. Calabrese were supported by the NIMH via Award Number K01-MH103080. T. Taggart was supported by the NIMH via Award Number T32-MH02003 and the National Institute on Drug Abuse (NIDA) via the HIV/AIDS, Substance Abuse, and Trauma Training Program at the University of California, Los Angeles (R25-DA035692). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health, the National Institutes of Health, or Planned Parenthood Federation of America, Inc.

Compliance with Ethical Standards

Conflicts of interest

S. K. Calabrese has received compensation for her efforts in developing and delivering PrEP education materials. S. Hull receives honoraria for serving on the PrEP for Women Steering Committee for Gilead and has a subcontract with a Gilead-funded research study. The authors do not have other conflicts of interest to disclose.

Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individuals included in the study.

Supplementary material

10461_2018_2283_MOESM1_ESM.docx (231 kb)
Supplementary material 1 (DOCX 231 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Mehrit Tekeste
    • 1
    Email author
  • Shawnika Hull
    • 2
  • John F. Dovidio
    • 3
    • 4
    • 5
  • Cara B. Safon
    • 4
  • Oni Blackstock
    • 6
  • Tamara Taggart
    • 2
    • 4
    • 5
  • Trace S. Kershaw
    • 4
    • 5
  • Clair Kaplan
    • 7
  • Abigail Caldwell
    • 7
  • Susan B. Lane
    • 7
  • Sarah K. Calabrese
    • 1
    • 4
    • 5
  1. 1.Department of PsychologyGeorge Washington UniversityWashingtonUSA
  2. 2.Milken Institute School of Public HealthGeorge Washington UniversityWashingtonUSA
  3. 3.Department of PsychologyYale UniversityNew HavenUSA
  4. 4.Yale School of Public HealthYale UniversityNew HavenUSA
  5. 5.Center for Interdisciplinary Research on AIDSYale UniversityNew HavenUSA
  6. 6.New York City Department of Health & Mental HygieneNew YorkUSA
  7. 7.Planned Parenthood of Southern New EnglandNew HavenUSA

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