A recent focus group–based study of Black women living in the South found they often harbored mistrust of a medical system they viewed as structurally and systemically racist. Such feelings, researchers argue, are key barriers to women in this demographic receiving quality HIV prevention services as well as care and treatment if they are living with the virus.

“[Our] results indicate that there are barriers to the utilization of health services that are grounded in personal experiences, historical mistrust for the health care system and systemic racism,” the study’s lead author, Schenita D. Randolph, PhD, MPH, of the Duke University School of Nursing, said in a press release. “HIV programs serving Black women should include conversations around structural racism and trust for both providers and patients.”

“Dr. Randolph’s findings are critical because they demonstrate women’s own views of the critical and sometimes subtle ways in which systemic racism can have dramatic effects on African-American women’s health through multiple pathways,” said Carol Golin, MD, of the University of North Carolina at Chapel Hill. “This suggests that working to dismantle racism is a fundamental step that is needed to fully address health disparities.”

In the study, which was published in The Journal of the Association of Nurses in AIDS Care, Randolph and her team conducted a series of focus groups with Black women living in low-income housing communities in a small Southern city.

Overall, the women consistently expressed that they saw the health care system as structurally racist and discriminatory toward them.

The women had low levels of trust in the health care system and believed that medical professionals hold back from providing comprehensive medical information to Black women or even provide them with false information.

They believed that being both Black and female compounded the discrimination they faced from the health care system.

To ensure they received proper medical care in the face of perceived discrimination, the women felt they had to become more assertive.


“These findings support the importance for health care providers, as well as researchers, to be aware of systemic racism and structural discrimination that may be overt or covert in our health care systems,” the study authors concluded. The investigators further stated that the women in the study strongly preferred to receive HIV-related communication and programming from “trusted individuals or gatekeepers” in the community.

To read a press release about the study, click here.

To read the study, click here.