ArticleBMC primary care2025
Demographic factors and correlates of trust in types of people and information sources: findings from the SAM-KAP Alabama youth survey on HIV prevention.
Article in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSexual and gender minority adolescents (SGM) experience higher rates of discrimination than heterosexual and cisgender peers, which may lead to adverse health behaviors, including condomless sex. Experienced discrimination and stigmatization may lead SGM adolescents to disproportionately seek information online around HIV risk and prevention. Understanding trusted sources of information among SGM adolescents is critical to addressing the HIV epidemic.
methodsTwo hundred six SGM adolescents, with male sex assigned at birth, aged 14-17 years, were recruited in-person from an LGBTQ-supportive school in Alabama, online via social media, and via a youth center. Respondents reported trust in information about pre-exposure prophylaxis (PrEP) from different types of people and information sources using a Likert scale with higher scores indicating greater trust. We utilized multivariable linear regression models to estimate the relationship between social support, self-efficacy, internalized homophobia, depression, discrimination, HIV, STI, and HIV prevention knowledge, and trust in types of people and information sources.
resultsWhite adolescents (n = 127) reported higher trust in HIV doctors (M: 4.83, SD: 0.92 vs. M: 4.72, SD: 0.81, p = .04) than Black adolescents (n = 63) who reported higher trust in religious leaders (M: 2.17, SD: 1.23 vs. M: 2.76, SD: 1.33, p = .002). Hispanic adolescents (n = 25) reported lower trust in straight friends/peers as compared to non-Hispanic peers (n = 167) (M: 2.42, SD: 1.16 vs. M: 3.19, SD: 1.10, p = .003). Social support and self-efficacy were significantly associated with trust in healthcare providers (β = 0.24, p = .013; β = 0.19, p = .040, respectively). Social support was associated with trust in family members (β = 0.23, p = .019). HIV prevention knowledge (β = 0.15, p = .046) and self-efficacy (β = 0.21, p = .010) were significantly associated with trust in Instagram. Self-efficacy was associated with trust in television commercials (β = 0.26, p = .009) and religious leaders (β = 0.20, p = .048).
conclusionSocial support and self-efficacy were salient correlates of trust. Self-efficacy may reflect the perceived ability to better care for oneself. Social support may lead SGM adolescents to self-select into healthcare from affirming providers, resulting in higher levels of trust in those providers. These findings indicate the potential value of bolstering social support and self-efficacy in preventative health interventions and may serve as a foundation for future intervention development to disseminate information about PrEP.
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