title: HIV/AIDS-related institutional mistrust among multiethnic men who have sex with men: effects on HIV testing and risk behaviors.
abstract: OBJECTIVE
  To investigate relationships between institutional mistrust (systematic discrimination, organizational suspicion, and conspiracy beliefs), HIV risk behaviors, and HIV testing in a multiethnic sample of men who have sex with men (MSM), and to test whether perceived susceptibility to HIV mediates these relationships for White and ethnic minority MSM.
  
  
  METHODS
  Participants were 394 MSM residing in Central Arizona (M age = 37 years). Three dimensions of mistrust were examined, including organizational suspicion, conspiracy beliefs, and systematic discrimination. Assessments of sexual risk behavior, HIV testing, and perceived susceptibility to HIV were made at study entry (T1) and again 6 months later (T2).
  
  
  RESULTS
  There were no main effects of institutional mistrust dimensions or ethnic minority status on T2 risk behavior, but the interaction of systematic discrimination and conspiracy beliefs with minority status was significant such that higher levels of systematic discrimination and more conspiracy beliefs were associated with increased risk only among ethnic minority MSM. Higher levels of systematic discrimination were significantly related to lower likelihood for HIV testing, and the interaction of organizational suspicion with minority status was significant such that greater levels of organizational suspicion were related to less likelihood of having been tested for HIV among ethnic minority MSM. Perceived susceptibility did not mediate these relationships.
  
  
  CONCLUSIONS
  Findings suggest that it is important to look further into the differential effects of institutional mistrust across marginalized groups, including sexual and ethnic minorities. Aspects of mistrust should be addressed in HIV prevention and counseling efforts.
authors: Psychological Sciences, University of California, Merced, CA, USA. mho0015@hunter.cuny.edu
authors: Michael A
authors: MA
authors: Hoyt
authors: Lisa R
authors: LR
authors: Rubin
authors: Carol J
authors: CJ
authors: Nemeroff
authors: Joyce
authors: J
authors: Lee
authors: David M
authors: DM
authors: Huebner
authors: Rae Jean
authors: RJ
authors: Proeschold-Bell
mesh_terms: D000328:Adult; D001130:Arizona; D001294:Attitude to Health; D003075:Coitus; D003695:Delivery of Health Care / Q000458:organization & administration; D005006:Ethnicity; D015658:HIV Infections / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control / Q000523:psychology; D006679:HIV Seropositivity; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D007325:Institutional Practice; D008297:Male; D008913:Minority Groups; D010349:Patient Compliance; D011287:Prejudice; D012306:Risk; D012309:Risk-Taking; D012725:Sexual Behavior; D035502:Trust; D047568:Unsafe Sex