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A Closer Look at Racism and Heterosexism in Medical Students’ Clinical Decision-Making Related to HIV Pre-Exposure Prophylaxis (PrEP): Implications for PrEP Education.
- Source :
- AIDS & Behavior; Apr2018, Vol. 22 Issue 4, p1122-1138, 17p, 2 Diagrams, 2 Charts, 1 Graph
- Publication Year :
- 2018
-
Abstract
- Social biases among healthcare providers could limit PrEP access. In this survey study of 115 US medical students, we examined associations between biases (racism and heterosexism) and PrEP clinical decision-making and explored prior PrEP education as a potential buffer. After viewing a vignette about a PrEP-seeking MSM patient, participants reported anticipated patient behavior (condomless sex, extra-relational sex, and adherence), intention to prescribe PrEP to the patient, biases, and background characteristics. Minimal evidence for racism affecting clinical decision-making emerged. In unadjusted analyses, heterosexism indirectly affected prescribing intention via all anticipated behaviors, tested as parallel mediators. Participants expressing greater heterosexism more strongly anticipated increased risk behavior and adherence problems, which were associated with lower prescribing intention. The indirect effect via condomless sex remained significant adjusting for background characteristics. Prior PrEP education did not buffer any indirect effects. Heterosexism may compromise PrEP provision to MSM and should be addressed in PrEP-related medical education. [ABSTRACT FROM AUTHOR]
- Subjects :
- HIV prevention
CONDOMS
HEALTH services accessibility
HEALTH status indicators
HELP-seeking behavior
HETEROSEXUALITY
CASE studies
PSYCHOLOGY of medical students
PREVENTIVE medicine
PATIENT compliance
RACISM
RISK-taking behavior
SURVEYS
DECISION making in clinical medicine
MEN who have sex with men
Subjects
Details
- Language :
- English
- ISSN :
- 10907165
- Volume :
- 22
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- AIDS & Behavior
- Publication Type :
- Academic Journal
- Accession number :
- 128815508
- Full Text :
- https://doi.org/10.1007/s10461-017-1979-z