An Experimental Study of the Effects of Patient Race, Sexual Orientation, and Injection Drug Use on Providers’ PrEP-Related Clinical Judgments

Sarah K. Calabrese, David A. Kalwicz, Djordje Modrakovic, Valerie A. Earnshaw, E. Jennifer Edelman, Samuel R. Bunting, Ana María del Río-González, Manya Magnus, Kenneth H. Mayer, Nathan B. Hansen, Trace S. Kershaw, Joshua G. Rosenberger, Douglas S. Krakower, John F. Dovidio

Research output: Contribution to journalArticlepeer-review


Social biases may influence providers’ judgments related to pre-exposure prophylaxis (PrEP) and patients’ consequent PrEP access. US primary and HIV care providers (n = 370) completed an experimental survey. Each provider reviewed one fictitious medical record of a patient seeking PrEP. Records varied by patient race (Black or White) and risk behavior (man who has sex with men [MSM], has sex with women [MSW], or injects drugs [MID]). Providers reported clinical judgments and completed measures of prejudice. Minimal evidence of racially biased judgments emerged. Providers expressing low-to-moderate sexual prejudice judged the MSM as more likely than the MSW to adhere to PrEP, which was associated with greater PrEP prescribing intention; sexual prejudice was negatively associated with anticipated MSM adherence. Providers judged the MID to be at higher risk, less likely to adhere, less safety-conscious, and less responsible than both the MSM and MSW; adverse adherence and responsibility judgments were associated with lower prescribing intention.

Original languageEnglish (US)
JournalAIDS and Behavior
StateAccepted/In press - 2021

All Science Journal Classification (ASJC) codes

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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