HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2005.063255v1 96/4/716    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (24) Citing Articles via Google Scholar Google Scholar Articles by Whetten, K. Articles by Stangl, D. Search for Related Content PubMed PubMed Citation Articles by Whetten, K. Articles by Stangl, D. Related Collections Social Science Access to Care HIV/AIDS Other Race/Ethnicity Rural Health Socioeconomic Factors

Kathryn Whetten, PhD, MPH, Jane Leserman, PhD, Rachel Whetten, MPH, Jan Ostermann, PhD, Nathan Thielman, MD, MPH, Marvin Swartz, MD and Dalene Stangl, PhD

Kathryn Whetten and Rachel Whetten are with the Center for Health Policy and the Health Inequalities Program, Duke University, Durham, NC. Jan Ostermann is with the Department of Community and Family Medicine and the Health Inequalities Program, Duke University. Nathan Thielman is with the Division of Infectious Diseases and International Health and the Health Inequalities Program, Duke University. Marvin Swartz is with the Department of Psychiatry and Behavioral Sciences, Duke University. Dalene Stangl is with the Institute of Statistics and Decision Sciences, Duke University. Jane Leserman is with the Department of Psychiatry, University of North Carolina, Chapel Hill.

Correspondence: Requests for reprints should be sent to Kathryn Whetten, Center for Health Policy, Box 90253, 125 Old Chemistry Bldg, Durham, NC 27708 (e-mail: k.whetten{at}duke.edu).

Objectives. We examined associations between trust of health care providers and the government and health service use and outcomes.

Methods. Interviews with a sample of 611 HIV-positive individuals included an attitudinal assessment measuring beliefs concerning the creation of AIDS, information being withheld about the disease, and trust of care providers.

Results. Trust in care providers was associated with increased HIV-related out-patient clinic visits, fewer emergency room visits, increased use of antiretroviral medications, and improved reported physical and mental health. Trusting the government was associated with fewer emergency room visits and better mental and physical health. More than one quarter of the respondents believed that the government created AIDS to kill minorities, and more than half believed that a significant amount of information about AIDS is withheld from the public. Ten percent did not trust their provider to give them the best care possible.

Conclusions. Distrust may be a barrier to service use and therefore to optimal health. Distrust is not isolated in minority communities but also exists among members of nonminority communities and equally interferes with their use of services and health outcomes.

This article has been cited by other articles:

				S. Kazi and S. Boroumand Assessing Quality of Primary Care Provided to the HIV-Infected Ryan White Population in the Baltimore Eligible Metropolitan Area American Journal of Medical Quality, November 1, 2008; 23(6): 484 - 491. [Abstract] [PDF]

				K. Whetten, S. Reif, R. Whetten, and L. K. Murphy-McMillan Trauma, Mental Health, Distrust, and Stigma Among HIV-Positive Persons: Implications for Effective Care Psychosom Med, June 1, 2008; 70(5): 531 - 538. [Abstract] [Full Text] [PDF]

				S. M. Bediako, A. R. Lavender, and Z. Yasin Racial Centrality and Health Care Use Among African American Adults With Sickle Cell Disease Journal of Black Psychology, November 1, 2007; 33(4): 422 - 438. [Abstract] [PDF]

				S. Reif, K. L. Geonnotti, and K. Whetten HIV Infection and AIDS in the Deep South Am J Public Health, June 1, 2006; 96(6): 970 - 973. [Abstract] [Full Text] [PDF]