The Association Between Healthcare Provider Trust and Healthcare Avoidance: Findings From a HIV Mixed Serostatus Cohort Study

Purpose Trust is a critical part of patient-provider relationships and has been shown to improve patient outcomes, including increased utilization of preventative services and greater adherence to medications. However, few studies have examined health care provider trust (HCPT) among older sexual minority men (SMM) and its association with healthcare avoidance. Design Cross-sectional secondary data analysis. Setting/Sample: Baseline data from the MACS/WIHS Combined Cohort Study’s Stigma and Non-Communicable Disease Syndemic Sub-Study (N = 997). Methods Multiple linear and multivariable logistic regression models were conducted to estimate associations between HCPT and past-year healthcare avoidance. Results Participants had a mean age of 59 years (SD = 13.3); 64% were White, 30% Black, and 5% identified as other races. Fifty-six percent were living with HIV. HCPT was lower among Black SMM (b = −2.23; 95% CI = −4.46, 0.00) and was positively associated with multiple income groups and having 1 (b = 3.80; 95% CI = 1.49, 6.11), 2 (b = 2.96; 95% CI = 0.67, 5.25), and 3 (b = 3.03; 95% CI = 0.53, 5.53) chronic health conditions. Past-year healthcare avoidance was inversely associated with HCPT (aOR = 0.95; 95% CI = 0.94, 0.97) and age (age 26-45 years vs 65-75 years, aOR = 0.26; 95% CI = 0.11, 0.58). Conclusion This work demonstrates various associations between healthcare provider trust and sociodemographic and health factors. Furthermore, lower HCPT was associated with a higher likelihood of avoiding medical care, indicating the importance of provider trust for accessing health services.