Title |
A Closer Look at Racism and Heterosexism in Medical Students’ Clinical Decision-Making Related to HIV Pre-Exposure Prophylaxis (PrEP): Implications for PrEP Education
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Published in |
AIDS and Behavior, November 2017
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DOI | 10.1007/s10461-017-1979-z |
Pubmed ID | |
Authors |
Sarah K. Calabrese, Valerie A. Earnshaw, Douglas S. Krakower, Kristen Underhill, Wilson Vincent, Manya Magnus, Nathan B. Hansen, Trace S. Kershaw, Kenneth H. Mayer, Joseph R. Betancourt, John F. Dovidio |
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. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 6 | 55% |
Italy | 1 | 9% |
United Kingdom | 1 | 9% |
Unknown | 3 | 27% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 8 | 73% |
Practitioners (doctors, other healthcare professionals) | 2 | 18% |
Scientists | 1 | 9% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 163 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 26 | 16% |
Student > Ph. D. Student | 20 | 12% |
Researcher | 15 | 9% |
Student > Doctoral Student | 11 | 7% |
Student > Bachelor | 11 | 7% |
Other | 29 | 18% |
Unknown | 51 | 31% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 33 | 20% |
Social Sciences | 23 | 14% |
Nursing and Health Professions | 19 | 12% |
Psychology | 18 | 11% |
Arts and Humanities | 3 | 2% |
Other | 9 | 6% |
Unknown | 58 | 36% |