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Relationship of African Americans' Sociodemographic Characteristics to Belief in Conspiracies About HIV/AIDS and Birth Control

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Relationship of African Americans' Sociodemographic Characteristics to Belief in Conspiracies About HIV/AIDS and Birth Control Relationship of African Americans' Sociodemographic Characteristics to Belief in Conspiracies about HIV/AIDS and Birth Control Laura M. Bogart, PhD and Sheryl Thorburn, PhD, MPH Santa Monica, California and Corvallis, Oregon N umerous news accounts as well as a small but Financial support: This research was supported by grant #5 growing amount of public health literature have RO HD42397 from the National Institute of Child Health and reported widespread belief in conspiracy theo- Human Development (Thorburn, principal investigator). ries about the U.S. government and healthcare system Although prior research shows that substantial proportions of among blacks, such as beliefs related to HIV, birth con- African Americans hold conspiracy beliefs, little is known trol and genocide.'-'2 In a particularly striking example, about the subgroups of African Americans most likely to Wangari Maathai, the Kenyan ecologist who won the endorse such beliefs. We examined the relationship of Nobel Peace Prize in 2004, publicly stated that western African Americans' sociodemographic characteristics to scientists deliberately created HIV for use as a their conspiracy beliefs about HIV/AIDS and birth control. bioweapon against Africans.'3 Research shows that Anonymous telephone surveys were conducted with a tar- blacks are much more likely to endorse such beliefs than geted random-digit-dial sample of 500 African Americans are whites.9"4'16 (15-44 years) in the contiguous United States. Respondents Researchers have hypothesized that conspiracy reported agreement with statements capturing beliefs in beliefs are one manifestation of African Americans' HIV/AIDS conspiracies (one scale) and birth control conspir- mistrust of the medical establishment, which stems acies (two scales). Sociodemographic variables included from decades ofinstitutional and interpersonal discrimi- gender, age, education, employment, income, number of nation in the U.S. healthcare system.4'7 Such discrimina- people income supports, number of living children, mari- tion is well documented and has included the segrega- tal/cohabitation status, religiosity and black identity. Multi- tion ofAfrican Americans into different hospitals, the variate analyses indicated that stronger HIV/AIDS conspira- conducting of unethical research such as the Tuskegee cy beliefs were significantly associated with male gender, syphilis study, and efforts to control the fertility of black identity and lower income. Male gender and lower African-American women.7-'9 Moreover, considerable education were significantly related to black genocide numbers of African Americans report experiencing conspiracy beliefs, and male gender and high religiosity interpersonal discrimination in healthcare in the recent were significantly related to contraceptive safety conspira- past and in their lifetime.'8'20-22 African Americans who cy beliefs. The set of sociodemographic characteristics have experienced discrimination or who are aware of explained a moderately small amount of the variance in historical discrimination in healthcare may be suspi- conspiracy beliefs regarding HIV/AIDS (R2 range=0.07-0.12) cious ofpublic health prevention messages and of infor- and birth control (R2 range=0.05-0.09). Findings suggest that mation supplied by health professionals and therefore conspiracy beliefs are not isolated to specific segments of more likely to endorse conspiracy beliefs.7 the African-American population. We have previously reported on a national survey of 500 African Americans of reproductive age in which a Key words: African Americans U conspiracy beliefs a substantial number of respondents endorsed conspiracy HIV/AIDS * birth control beliefs regarding the origin and treatment of HIV/AIDS; the safety and testing ofbirth control methods; and the use © 2006. From RAND Corp., Santa Monica, CA (Bogart) and Department of ofbirth control to control, limit or eliminate the black pop- Public Health, Oregon State University, Corvallis, OR (Thorburn). Send corre- ulation."' 2 For example, our research indicated that over spondence and reprint requests for J Natl Med Assoc. 2006;98:1144-1150 to: half of the endorsed con- Dr. Laura M. Bogart; phone: (310) 393-0411 x7109; fax: (310) 260-8159; e-mail: sample (53%) the HIV/AIDS [email protected] spiracy belief, "There is a cure for AIDS, but it is being withheld from the poor," and nearly half (48%) believed that "HIV is a manmade virus." Similarly, considerable 1144 JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION VOL. 98, NO. 7, JULY 2006 SOCIODEMOGRAPHIC CHARACTERISTICS AND CONSPIRACY BELIEFS proportions ofthe sample endorsed birth control conspira- of black genocide (e.g., that HIV and/or birth control cy beliefs regarding black genocide, including the belief are part of a government plot to wipe out African Amer- that "Whites want to keep the numbers of black people icans).6'7'23 Strong black identification also has been down" (33%) and that "The government's family planning associated with greater belief in conspiracies about policies are intended to control the number ofblack peo- HIV,7 possibly because stronger identification may be ple" (22%). Many respondents also agreed with birth con- related to a greater knowledge of black culture and his- trol conspiracies regarding contraceptive safety, such as, tory with respect to racism in the United States.24 "Medical and public health institutions use poor and The relationship of socioeconomic status (SES) to minority women as guinea pigs to try out new birth con- endorsement of conspiracy beliefs is less straightfor- trol methods" (37%). ward. One study found that black men with a college Our prior research also found that conspiracy beliefs versus high-school education are more likely to endorse are significantly associated with condom use and contra- conspiracies.7 This suggests that individuals who are ceptive behaviors. African-American men who strongly more educated may be more knowledgeable about the endorsed HIV/AIDS conspiracy beliefs were less likely to historical problems faced by African Americans and, use condoms consistently, suggesting that beliefin conspir- hence, may more readily endorse conspiracy theories. In acies may be a barrier to HIV prevention.' Furthermore, contrast, other research has demonstrated that lower lev- men with stronger conspiracy beliefs about the safety of els ofeducation and income are associated with stronger contraceptives were less likely to be using any birth con- conspiracy beliefs,9 and that lower levels of educational trol.'2 Among women currently using birth control, those attainment and unemployment are related to greater with stronger contraceptive safety conspiracy beliefs were mistrust of research and the medical establishment.23 less likely to be using methods that must be obtained from Researchers have hypothesized that individuals with a healthcare provider, which are the most effective methods low SES may endorse conspiracies because they seek a for preventing pregnancy. Whether about HIV/AIDS or way to explain their alienation and lack of control in birth control, African-American men were more likely than society.'4 Thus, belief in conspiracies may serve as a African-American women to endorse conspiracy beliefs. coping mechanism to protect self-esteem by placing With the exception of research on gender differ- blame for disadvantage on an overall, racist system."5 ences, prior work has not comprehensively examined In sum, large proportions ofAfrican Americans report the characteristics ofAfrican Americans who are most mistrust of the U.S. healthcare system and conspiracy likely to endorse a range of conspiracy beliefs in terms beliefs related to the government's role in genocide of of their background and sociodemographic characteris- African Americans, HIV/AIDS and birth control. A small tics. Such information would assist health researchers amount ofprior research suggests small and mixed effects and practitioners in identifying the subgroups most mis- of sociodemographic characteristics on the endorsement trustful ofthe healthcare system, allowing for more effi- of conspiracy beliefs. Hence, in the present study, we cient implementation of cultural- ly tailored interventions. For Table 1. Characteristics of-respondents (N=500) example, to the extent that specif- ic subgroups of African Ameri- Characteristic n % cans are more likely to endorse Age (Years), M=27.4 ± 8.9 conspiracies, targeted prevention 15-20 152 30.4 messages could be developed for 21-34 223 44.6 greater effect. In the absence of 235 125 25.0 sociodemographic differences in Gender Male 174 34.8 conspiracy beliefs, culturally tai- Female 326 65.2 lored prevention efforts directed Education at African Americans more gen- High-school graduate or less 255 51.0 erally may be appropriate. Some college/technical school or college graduate 245 49.0 A small number of earlier Currently Working 336 67.2 studies have uncovered sociode- Annual Household Income from All Sources (n=444) correlates of medical <$35,000 237 53.4 mographic 2$35,000 207 46.6 mistrust as well as conspiracy Currently Married/Living with Partner 185 37.0 beliefs. Compared to African- Number of Children American women, African- None 238 47.6 American men are more likely to .1 262 52.4 mistrust the healthcare system Fifty-six respondents did not report their income, and 58 respondents did not report the and medical research and to number of people their income supports. endorse conspiracies indicative JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION
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