{"doi":"10.17615/kb44-0t86","title":"Medical Mistrust of Health Systems as a Moderator of Resilience and Self-Reported HIV Care Engagement in Black and Latinx Young Adults Living With HIV","abstract":"OBJECTIVE: To study resilience and its association with HIV care engagement in a sample of young adult Black and Latinx people living with HIV (PLWH) in the United States and to test if a systems-level barrier, medical mistrust, would moderate the resilience-engagement association. METHOD: Between April and August 2021, we recruited participants through social media and dating apps (<em>N</em> = 212) and verified age and HIV status through a review process of digital text-messaged and emailed photos. Participants completed a one-time online survey consisting of the Connor-Davidson Resilience Scale, The Index of Engagement in HIV Care, and the Medical Mistrust Index. We ran a regression-based moderation analysis using the Johnson-Neyman Technique to estimate regions of significance. RESULTS: The sample (<em>N</em> = 212) was 80.5% Black and 19.5% Latinx with a mean age of 25.8 years (<em>SD</em> = 2.84). Higher resilience scores were associated with higher HIV care engagement scores (<em>b</em> = 0.72, <em>p</em> = .003), and medical mistrust moderated this relationship as evidenced by a mistrust by resilience interaction (<em>b</em> = -0.16, <em>p</em> = .01). Our regions of statistical significance showed that as mistrust increased, the size of the resilience-engagement association decreased. CONCLUSION: Resilience may be a protective factor associated with greater participation and sense of connection to HIV care, but is diminished by mistrust of the medical system at large. This suggest that systems-level changes, in addition to individual-level interventions, are needed to address medical mistrust to fully harness the resilience of young PLWH.","journal":"UNC Libraries","year":2025,"id":578319,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9467,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":404317,"name":"John A. Sauceda","orcid":"0000-0003-1975-3080","position":1,"is_corresponding":false},{"id":880471,"name":"Samuel Ndukwe","orcid":null,"position":2,"is_corresponding":false},{"id":950228,"name":"Chadwick K. Campbell","orcid":"0000-0002-8609-5762","position":3,"is_corresponding":false},{"id":291761,"name":"Parya Saberi","orcid":"0000-0002-3793-5112","position":4,"is_corresponding":false},{"id":299395,"name":"Karine Dubé","orcid":"0000-0003-3458-1539","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:58:20.638044Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}