BACKGROUND

It is estimated that 1 of every 50 African-American males is infected with HIV For black men who have sex with men (BMSM), the prevalence estimates are 33% for 15-29-year-old BMSM in some major metropolitan cities. Up to 93% of these men are unaware of their HIV status, which may influence severity of disease at diagnosis for BMSM, as well as overall morbidity and mortality rates.

While a number of individual, behavioral, and knowledge-based variables may explain part of this disparity, little is known about the role that BMSM’s healthcare experiences play in this epidemic. Physician-negative perceptions of African Americans as less educated, less intelligent, and less pleas­ant influence their expectations of these patients to engage in risk behavior and follow medical advice.  Physicians’ prediction that African-American men are less likely to adhere to highly active antiretroviral therapy (HAART) influences their treatment decisions, including rates of prescribing prophylactic medications for opportunistic infections. Moreover, HIV-positive black men’s perceptions of physician competence and support may influence their adherence to protease inhibitors. canadian pharmacy support net

Communication, trust, and issues of support in the doctor-patient relationship are important variables influencing medical utilization and adherence among African Americans, particularly when perceived race-based discrimination exists. African Americans with HIV/AIDS utilize fewer outpatient and more inpatient care than their white counterparts, even when controlling for insurance and socioeconomic status. This heavy reliance on inpatient and emergency room (ER) facilities leads to worse HIV health outcomes, while increased outpatient support and ancillary services lead to improved adherence, increased clinic retention rates, and decreased hospital admission rates.

Little is known regarding the qualitative relationship between the healthcare experiences of BMSM and their utilization behaviors. Given the unique social circumstance of being both black and homosexual, and the current HIV disparity in this population, the specific aims of this study were to qualitatively describe the: 1) healthcare experiences of BMSM; 2) perceived influence of their race and sexuality on these experiences; 3) perceived barriers to healthcare utilization; 4) quality of doctor-patient communication; and 5) factors affecting adherence in this population. online pharmacy without a prescription