HIV Beliefs Among African Americans with HIV/AIDS in the Deep South Can Time Heal Old Wounds?
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Original Article
DOI: https://doi.org/10.36502/2021/hcr.6191
HIV Beliefs Among African Americans with HIV/AIDS in the Deep South
Can Time Heal Old Wounds?
Sharon Parsons1*
1
Grand Canyon University, Phoenix, AZ, USA
Corresponding Author: Sharon Parsons, PhD ORCID iD
Address: Grand Canyon University, 3300 Camelback Rd, Phoenix, AZ 85017, United States. Email:
Received date: 19 March 2021; Accepted date: 30 April 2021; Published date: 11 May 2021
Citation: Parsons S. HIV Beliefs Among African Americans with HIV/AIDS in the Deep South Can Time Heal Old
Wounds? J Health Care and Research. 2021 May 11;2(2):70-84.
Copyright © 2021 Parsons S. This is an open-access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original
work is properly cited.
Abstract
This study explored rumors about HIV among HIV+ African Americans in Louisiana, comparing the results
of surveys conducted in 2000/2001 and 2010/2011. This investigation sought to determine if the passage of
time would diminish malicious intent and benign neglect beliefs. The study employed quantitative descriptive
statistics to produce the comparison. This research should be considered exploratory only because of the
stated limitations. The results indicated that the benign-neglect belief of government truthfulness about the
disease had not diminished in the decade. In contrast, the strength of belief in the malicious-intent rumor of
HIV/AIDS as genocide had declined. The study further examined relationships between the HIV beliefs and
certain characteristics of the samples. Bivariate analyses revealed that education was not related to HIV beliefs
in 2000/2001 but was related to the HIV/AIDS as genocide in 2010/2011. Further, emotional well-being was
mildly related to HIV beliefs in both samples. Several recommendations are offered for future research.
Although this study frequently used the term “conspiracy” – the common nomenclature for this type of
research, the author joins with others to caution researchers to rethink labeling these beliefs among African
Americans as conspiracies. That label too easily casts Black Americans in a light as being paranoid rather than
understandably suspicious considering the lived experiences of that group in the Deep South.
Keywords
HIV Rumors, HIV/AIDS, African Americans, Louisiana, Deep South
Introduction and Background alarming rate of HIV and AIDS cases. In 2010, Baton
This quantitative descriptive study examined the Rouge ranked first in estimated AIDS case rates and
strength of belief in HIV rumors among HIV+ African African Americans represented 78% of the newly-
Americans using data collected in 2000/2001 and diagnosed AIDS cases and 74% of the newly-diagnosed
2010/2011 from residents in the metro area of Baton HIV cases in the state [1]. The disproportionate impact
Rouge. This investigation sought to determine if a of HIV/AIDS on African Americans continued into the
lapse in time could diminish malicious intent and next decade with that racial group representing nearly
benign neglect HIV beliefs. Baton Rouge gained three-fourths of newly-diagnosed AIDS and HIV cases,
national attention from 2000 to 2010 because of the although comprising less than one-third of Louisiana’s
Manuscript no: JHCR-2-70 Volume: 2 Issue: 2 70
J Health Care and Research
Citation: Parsons S. HIV Beliefs Among African Americans with HIV/AIDS in the Deep South Can Time Heal Old
Wounds? J Health Care and Research. 2021 May 11;2(2):70-84.
Original Article
population. Of any group, African Americans have confirmed that HIV/AIDS conspiracy beliefs were
reason to be suspicious of American institutions. common among African Americans [21-26].
The year 2021 was ushered in with a mob storming What matters to reducing HIV rumors? Research on
the US Capitol, egged on by the president and ignited these beliefs is still in its infancy [27] with few insights
by the belief that the presidential election had been offered on whether these beliefs can change; and, if so,
stolen. Multiple extremist groups participated in the why. Rational arguments may help as scientific
insurrection with the QAnon conspiracy believers, information becomes available, and ridiculing may
center front. QAnon embraces not only the conspiracy work on some myths and in some cultures [28].
of a stolen election but a wide variety of other beliefs However, it is indefensible and counter-productive to
hovering around a day of reckoning of those attempt to delegitimize or to label these beliefs as
controlling the “Deep State” government [2]. Deep irrational for African Americans [29] considering the
State conspiracy theorists may be on the political anti- glaring evidence of government’s complicity in
government fringe, but half of Republicans still breaches of medical ethics and connecting the dots
contend that the election was stolen from Trump [3]. from slavery to current discriminatory treatment.
Beliefs in covert or overt US government Medical rumors among African Americans are the
manipulations and cover-ups are not new and surface manifestation of deep-rooted distrust, and
sometimes even probable. Nonetheless, there is a line while this author agrees that public health officials
that can be drawn between fake-landing-on-the-moon should try to “patiently” refute medical conspiracy
versus conspiracies of malicious intent [4] – the willful beliefs, that approach could produce a “backfire effect”
agenda by government to harm or even eradicate and increase skepticism [30]. Greater education may
certain groups. Such malicious beliefs and mistrust or may not matter to the belief in conspiracy rumors,
can have far reaching consequences for the believers. but as Simmons and Parsons [31] discovered, the level
Prior studies have documented that distrust in of education of African Americans in Louisiana was not
government can negatively alter health behavior and a buffer against believing rumors, such as believing in
decisions [5-7] including HIV treatment [8-11] and, HIV/AIDS as genocide of Blacks. The same findings
most currently, compliance with Covid-19 protocols have been confirmed by other studies as well [24,26].
and willingness to be vaccinated [12,13].
The current study sought to determine if time is a
The “mysterious” AIDS origin first plaguing possible antidote in reducing the intensity of HIV
homosexuals, Haitians, hemophiliacs and heroin users beliefs among African Americans with HIV. Findings in
(the 4H disease) [14] was fodder for the rumor mill. a companion article by Parsons [32] indicated that a
Two years after HIV was identified as the cause of decade made no difference in believing HIV/AIDS to be
AIDS, Black women comprised 51% of all AIDS cases a punishment from God. However, disease-inception
among women, and by 1990, African Americans conspiracies are different. The lack of scientific
surpassed whites in new infections and this disparity understanding of devastating diseases such as
remains today [15]. Not surprisingly, rumors about the HIV/AIDS results in the likelihood of “folkloric”
suspicious inception of HIV/AIDS sprouted in the Black explanations to bridge the vacuum [33]. A mysterious
community and by 1997/1998, the grapevine among fatal disease can incite insecurity and fear [34] with
African Americans was up and running with a notable the resulting rumors often more hazardous than the
percentage of Blacks believing in a genocidal disease itself [35]. The question remains – does time
conspiracy. [4,16-19]. The 2008 pulpit recording of reduce such beliefs?
Barack Obama’s pastor, Jeremiah Wright, implicating
government in the HIV/AIDS extermination of Blacks Why could time potentially create distance in a
[20] shocked White America but not Black Americans. medical rumor? First, 10 years may matter because of
Study upon study in the early decades of the epidemic greater public health efforts, in that decade, to include
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J Health Care and ResearchCitation: Parsons S. HIV Beliefs Among African Americans with HIV/AIDS in the Deep South Can Time Heal Old
Wounds? J Health Care and Research. 2021 May 11;2(2):70-84.
Original Article
consumers on local and regional boards as well as to work in HIV services, or who serve a large HIV+
place more emphasis on support groups. Consumers population, were asked to comment on the draft
with HIV also became more visible and active in peer- instrument. Revisions were made to the instrument,
support and outreach endeavors, thus, building per the comments received. The survey was last field-
credible bridges to share information with the tested using a small number of consumers of
community. With those efforts, it is likely that a decade HIV/AIDS services. Both data collections extended
made a difference in opportunities to participate in approximately nine months and both were approved
forums and speak openly about beliefs without being by the university IRB. In compliance with the IRB
judged [36]. Such group member interactions could requirements, prior to the administration of any
further the “sense making” process of rumors with an survey, the reason for the study was explained,
eventual loss of interest in the rumor [37]. Second, voluntary participation was emphasized and privacy
time alone may lessen medical rumors. For example, provided for survey completion. A small incentive was
Bierwiaczonek et al. [38] collected longitudinal data on offered to each participant. Approximately half of both
Covid 19 conspiracy beliefs and found that those beliefs samples requested that the questions be read to them
decreased over time. Third, while the evidence is slim, and the responses recorded by the investigators.
the stigma of certain disorders may decrease over time
or with interventions [39-42]. HIV stigma decreased in Demographic questions were included but without
the United States in the decade prior to 2000 [43], and any identifier that could personally link the participant
a reduction in stigma could potentially reduce to the paper survey. Among those respondent
misconceptions about HIV [44]. characteristics questions were age/year of birth,
race/ethnicity, HIV risk factor, gender, education,
While the intensity of rumors may lessen with time, emotional well-being, and treatment adherence. Two
it is equally possible that the persistence of HIV questions in the surveys, formatted from strongly
rumors among African Americans has not diminished disagree to strongly agree, examined the strength of
in a decade. Early in the HIV epidemic, a sizable belief in rumors about HIV/AIDS and were adapted
percentage of African Americans believed HIV from the research by Thomas and Quinn [19] and
rumors and the general distrust of American Quinn [53]: The government is telling the truth about
institutions was fertile ground to quickly root rumors HIV/AIDS and I believe that AIDS is intended to wipe
about HIV. In-depth interviews with African blacks off of the face of the.
American veterans, receiving HIV treatment through
the Veterans Health Administration, revealed the Samples and Location:
resilience of both the HIV conspiracy beliefs and The 2000/2001 survey data were collected from
the grapevine echoing those beliefs [45]. Although HIV+ individuals at HIV/AIDS service providers,
studies rarely track HIV conspiracy beliefs over including a food bank. Participants for the 2010/2011
time, publications in the past decade still provide survey were solicited from both HIV/AIDS service
ample evidence of the persistence of these beliefs providers and from health fairs held in at-risk
[46-52]. neighborhoods in Baton Rouge. It is unknown if any of
the participants in the 2000/2001 survey also
Methods responded to the 2010/2011 survey. Consider that the
Materials: survival rate for new AIDS diagnosis in 2001 was 74%
Data were collected through multipurpose surveys after 36 months and for those 50 and older the rate
of participants in the Louisiana Public Health Region II plummeted to between 46% to 69% depending on the
metro area of Baton Rouge, Louisiana, in 2000/2001 age, and if injection drugs were involved the survival
and again in 2010/2011. The questions examined in rate dropped again [1].
this study were attached to general needs assessment
surveys. As a part of the 2000/2001 survey field The Louisiana Public Health Region II, in 2010,
testing, local practitioners and administrators who included both urban and rural parishes (counties):
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J Health Care and ResearchCitation: Parsons S. HIV Beliefs Among African Americans with HIV/AIDS in the Deep South Can Time Heal Old
Wounds? J Health Care and Research. 2021 May 11;2(2):70-84.
Original Article
East Baton Rouge, West Baton Rouge, West Feliciana, and psychological well-being.
East Feliciana Ascension, Iberville, and Pointe Coupee.
Most of the respondents for both surveys resided in the Three hundred and six surveys were collected
city of Baton Rouge. However, among the data 2000/2001, with African Americans representing the
collected at Region II HIV/AIDS service providers in majority of the respondents. Two hundred and forty-
Baton Rouge, rural residents would have been four responded in 2010/2011 with the majority of those
represented in those accessing those services. African American and those with HIV. The final tally of
those African American HIV+ participants was 124 for
Louisiana is a state long plagued by poverty, poor the 2000/2001 sample and 169 for the 2010/2011
educational outcomes, segregated schools and sample in the metro Baton Rouge area. For the
neighborhoods, health care disparities, high primary analysis of the two samples, the categories of
incarceration rates, racial inequality, sexually disagree and agree were collapsed with “unsure”
transmitted diseases and HIV. As of 2010 [1], 17,679 responses deleted. The rumor belief data for both
(15,178 urban and 2,501 rural) persons were reported surveys were archived by the researcher until this
to be living with HIV in Louisiana and of those current comparison.
approximately half had been diagnosed with AIDS.
Over one-third of those with an HIV diagnosis in 2010 Both surveys inquired about age with birth year in
were not in medical care for the disease [1]. Notable the 2000/2001 sample and age categories in the
also was the high rate of STDs, according to the 2010/2011 sample. There was a range of 43 years from
Louisiana STD/HIV Program Report [1]: first in the the oldest to the youngest in the 2000/2001 sample. Of
rate of primary and secondary syphilis and congenital the 124 responding, 24 were younger than 30 and 21
syphilis, second in the rate of gonorrhea, and third in were 50 or older at the time of the data collection. The
the rate of chlamydia. mean and median birth year was 1961/1962 for that
first sample. Of the 2010/2011 sample, the plurality
In 2010, the HIV diagnosis rate per 100,000 was (49, 30%) were 35 – 44 years old and only 9% (15)
46.0 in the Baton Rouge metro area with a total were 24 years old or younger with 13% (22) 55 years
population in Region II of 663,255 [1]. In that same or older. The sample was somewhat older than the
year, Baton Rouge had the highest AIDS diagnosis rate state statistics for those newly diagnosed with HIV 55
of all regions in the state [1]. The new HIV diagnosis years of age or older (8.4%) but reasonably close to
numbers in the Baton Rouge region per year were the percentage of those 55 and older at the time of
relatively stable from 2001 to 2010 (302 and 305, for AIDS diagnosis in the state (12%) in 2010 [1].
the latter); the same was true for the new AIDS
diagnosis for the region (240 and 238, for the latter) Educational level was low in the two groups;
[1]. Most of those new HIV and AIDS diagnoses for nonetheless, 34% of the 2010/2011 sample did not
Region II were in East Baton Rouge parish, where the graduate from high-school compared to 44% the
city of Baton Rouge is located [1]. previous decade. Most of the respondents were
unemployed. Approximately 10% (12) of the
Analysis 2000/2001 sample reported full- time employment
and 13% (15 of 118) reported part time employment.
Profile of the Samples:
Eighty-four percent of the 210/2011 sample reported
Only descriptive statistics (percentages and bivariate
not being employed full time (139) and few (14)
statistics) were used to analyze and display the results.
reported being part-time employees at the time of the
First, the analysis will present demographic
data collection.
characteristics of both samples, followed by the
comparison of HIV beliefs in the two data collection
There were few meaningful differences between the
periods. Last, a small section is dedicated to exploring
two samples in terms of their perceived health status.
the relationship between HIV rumors and two concepts
Among the 2000/2001 group, 15% (18 of 119
of interest to the current body of literature – education
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J Health Care and ResearchCitation: Parsons S. HIV Beliefs Among African Americans with HIV/AIDS in the Deep South Can Time Heal Old
Wounds? J Health Care and Research. 2021 May 11;2(2):70-84.
Original Article
responding) and 17% (28 of 164) of the 2010/2011 destruction of the levees to rid the city of Blacks were
reported their health to be excellent. There was a rampant [58,59]. Even the decision of some African
difference between the two samples in terms of Americans to shelter in place rather than evacuate
emotional well-being. Twenty-one percent (of 121 New Orleans was due, in part, to the perceived racism
responding in the 2000/2001 sample) and 33% (of 131 and inequities in the state [60]. There is not a corner
responding in the 2010/2011) agreed that they were in the life of African Americans in Louisiana untouched
always happy. Interestingly, of the 2010/2011 sample, by racism and distrust of the motives of authorities in
the plurality (43% of 160 responding) agreed that the the state [57,61-70]. Distrust must be understood as
quality of life was the same pre- and post-HIV history or experienced culture [36], and in the case of
diagnosis. That question was not asked the prior African Americans in the Deep South, it is both.
decade.
In contrast, the respondents in 2010/2011 were less
There were approximately the same number of likely to believe that HIV/AIDS was intended as a
males as females in both samples of HIV+ African means to the genocide of African Americans. As stated
Americans. For more information on the demographic earlier, a decade could make a difference in the
details of the surveys, please see Parsons [32] and advancement of information about the origins of
Parsons et al. [54]. Of the 2000/2001 sample, one- HIV/AIDS as well as greater consumer participation
third reported injection drug use (IDU) as a disk factor and outreach. Some rumors may have a shelf life, not
-- approximately the same percentage of exposure was necessarily to be completely dismantled, but still to
reported by the state that year [55]. Only 16% of the lack sustainability. Further, the results suggest that the
2010/2011 sample reported IDU as a risk factor. In difference between the two rumors is the distinction
2009, IDU accounted for 13% of new HIV diagnosis between benign neglect and the belief in malicious
among African Americans and 20% of persons, intent. The government is telling the truth about
regardless of race, living with HIV [56]. Questions on HIV/AIDS can be categorized as benign neglect while I
incarceration were not asked in the 2000/2001 survey believe that AIDS is intended to wipe blacks off of the
and, as Parsons reported in 2020 [57], approximately face of the earth is a malicious intent rumor. Beliefs in
half of the 2010/2011 sample had been incarcerated. malicious intent assume a specific plan (by
government, large corporations and so forth) to do
HIV/AIDS Rumors harm, while beliefs in benign neglect center on a
The respondents were somewhat less likely to neglectful, but not necessarily genocidal government -
believe that government was telling the truth about possibly knowing about problems but turning a blind
HIV/AIDS in 2010/2011 (Table-1). The finding was not eye, a laissez faire attitude, and a failure to protect
surprising due to the general distrust of African [4,71]. Benign neglect beliefs are more prevalent and
Americans in government; thus, there was no reason both categories of theories among African Americans
to anticipate a reversal of that belief at least in are related to powerlessness to influence government
Louisiana. In that decade, Hurricane Katrina destroyed and racial discrimination [25].
swaths of Louisiana, and rumors about the intentional
Table-1: Beliefs among HIV+ African Americans (responses rounded)
2000/2001 HIV+ AA
2010/2011 HIV+ AA Responses
HIV Beliefs Responses
Disagree/False Agree/ True Disagree/False Agree/True
Government is Telling the Truth about 38% 62% 27% 73%
HIV/AIDS -73 -45 -33 -91
I believe that HIV/AIDS was intended to 81% 19% 61% 39%
wipe Blacks off the face of the earth -111 -26 -74 -48
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J Health Care and ResearchCitation: Parsons S. HIV Beliefs Among African Americans with HIV/AIDS in the Deep South Can Time Heal Old
Wounds? J Health Care and Research. 2021 May 11;2(2):70-84.
Original Article
This final section is intended as a very limited than those agreeing (24). Of those reporting that they
exploration of the two data sets and highlights a few started medical treatment at the time of diagnosis in
interesting differences over the decade. First, the two 2010/2011, 56 (of 60) disagreed that HIV/AIDS was
HIV beliefs were not related in 2010/2011 (.104, p = meant as genocide, and 52 of 65 agreed that that
299), but they were a decade before (-.269, p = 003). government was telling the truth. Other studies have
Possibly, in 2000/2001 there was a general distrust concluded that conspiracy beliefs are not related to HIV
with one belief rippling into another, while ten years treatment delays or adherence [72,73] although this
later the participants had drawn an intuitive line debate remains ongoing.
between the two, likely because of the distinctive
nature of malicious versus benign beliefs. Bivariate analyses indicated that the age of the
respondents (year of birth, from earliest to most
Since the original sample in 2000/2001 included 24 recent) was not related to either of the HIV rumors in
white respondents, a comparison of beliefs based on 2000/2001 (HIV/AIDS as genocide: -.105, p = 252;
race was restricted but still noteworthy. Surprisingly, a government truthfulness about HIV/AIDS: -.054, p =
larger percentage of white respondents (63% 563). The relationships between age (categories from
compared to 27% of the Black respondents) disagreed youngest group to the oldest group) and beliefs
that government was telling the truth about HIV/AIDS. (disagree or agree) in 2010/2011 sample were not
But, as expected, 88% (21) disagreed that HIV/AIDS statistically significant (genocide, 8.936, p = 112;
was meant as genocide of Blacks, compared to 39% of truthfulness, 4.472, p = 346) and the cases were too
the African American respondents. There were too few few in each cell to draw any certain conclusions.
white participants in the 2010/2011 original sample for Nonetheless, of any age category, those 45-54 were less
any comparisons based on race. likely to believe HIV/AIDS was genocide (29 of 32).and
more likely to believe that government was telling the
The initial sample in 2010/2011 included those who truth about HIV/AIDS (14 of 17).
reported that they were HIV negative as well as
positive and this allowed a limited comparison of Educational level of the HIV+ African American
beliefs. Of those responding ‘agree’ or ‘disagree’ to the participants in 2000/2001 was not related to either
question and reporting that they were HIV-, 44% (16 belief, but education was a factor in 2010/2011.
of 36) disagreed that government was telling the truth Education was measured from lowest to highest (8th
and 86% (38 of 44) disagreed that HIV/AIDS was grade or less to college degree). A lower educational
intended as genocide. These findings suggest that level in 2010/2011 was accompanied by a greater belief
those African Americans, both HIV positive and in the malicious intent of HIV/AIDS as genocide. This
negative, shared the same intensity of beliefs. finding is important and may indicate that education
gains traction in disease-inception beliefs with the
Both surveys included questions on medical care for passage of time.
HIV. The 2000/2001 results suggested no clear
connection between HIV beliefs and the decision to not 2000/2001 – AIDS as genocide and education
start medical care, or come and go in medical care or level (.041, p = 655)
stay in medical care since diagnosis(uninterrupted). 2010/2011 – AIDS as genocide and education level
The same number of those in uninterrupted medical (-.349, p = 000)
care since diagnoses agreed and disagreed (27 each) 2000/2001 – Government telling the truth and
that government was telling the truth and of the 99 education level (-.041, p = .655)
self-reporting uninterrupted medical care and who 2010/2011 – Government telling the truth and
responded to the questions, 31 disagreed that education level (.046. p = 624)
HIV/AIDS was genocide (compared to 24 who agreed).
Of those in 2010/2011 reporting uninterrupted medical The belief that government was telling the truth
care, more (31) disagreed that HIV/AIDS was genocide about HIV/AIDS was related to greater satisfaction
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J Health Care and ResearchCitation: Parsons S. HIV Beliefs Among African Americans with HIV/AIDS in the Deep South Can Time Heal Old
Wounds? J Health Care and Research. 2021 May 11;2(2):70-84.
Original Article
with medical services (not satisfied to very satisfied) in acknowledging IDU as a risk factor. As the preceding
2000/2001 (.358, p = .001), but the relationship analysis affirmed, the percentages of those self-
between satisfaction and HIV as genocide was not reported IDU for both data sets, matched or exceeded
statistically significant (.184, p. = .051). A general state statistics. Third, there is an inherent problem in
question on satisfaction with medical care was missing comparing two populations that are unlikely to be the
in the 2010/2011 data since that question was asked same individuals. It would be then impossible to know
per service provider. if the beliefs had changed over time in the same
individuals. Obviously, the 2010/2011 data are now
The survey in 2010/2011 included a few questions another decade old; therefore, the author passes on
related to emotional well-being and the 2000/2001 that baton to future researchers to determine most
survey included one such question. The HIV/AIDS current beliefs of African American with HIV in
genocidal belief, but not government truthfulness, was Louisiana.
mildly related to aspects of emotional health. Greater
perceived stigma (People are afraid to be around This study was specific to the metro area of Baton
someone with HIV - very true to very false), Rouge, Louisiana, and by choice to the use a
hopelessness (I do not have a great deal of control over convenience sample. Most similar research is specific
what happens to me - very true to very false), and to a certain geographical location, time, and
mood (Do you feel happy? - never to always) were population, and cross-sectional. The choice of
related to stronger genocidal belief in 2010/2011, and Louisiana, or any Deep South state, is likely to matter
the belief was marginally related to mood in the the most in attempting to compare results to studies in
2000/2001 results. other regions. If there is any place that would
germinate rumors among African Americans, it is this
2010/2011 Stigma: (-.198, p = 021) region. Louisiana is “Jim Crow’s Last Stand” [74], and
o Compared to - government is telling the the unthinking and deliberate suppression of African
truth: (-.018, p. = 848) Americans in the state created second-class citizens
2010/2011 Hopelessness: (-.418, p = 001) with reasons to distrust the motives of those in
o Compared to - government is telling the authority. One could argue that the puppeteering that
truth: (-.050, p. = 519) maintains the systemic racism in the Deep South is the
2010/2011 - Mood: Do you feel happy? (never to real “deep state” rather than the odd assortment of
always) (-.239, p = .012) conspiracy beliefs of White Americans. The dynamic of
o Compared to - government is telling the “White Fragility” of White Americans can spur a need
truth: (.030, p. = 726) to “reinstate white equilibrium” [75] including the
2000/2001 - Mood: (-.200, p = .029) endorsement of certain conspiracy theories with racial
o Compared to - government is telling the hostility undergirding those beliefs [76]. Consider the
truth: (.117, p. = 200) success of former Ku Klux Klansman, David Duke, a
decade just prior to the first data collection for the
Conclusions and Recommendations current study, goading white voters to reinstate white
This study offered only a glimpse into the equilibrium in Louisiana. Duke won a large cross-
endorsement of HIV rumors among African Americans section majority of Louisiana’s white vote in three state
with HIV in Louisiana, comparing beliefs from the elections [77], using rhetoric that stoked white
window of one decade to the next. This research is resentment with “Jewish Plots” and by blaming Blacks
exploratory with major limitations. First, no attempt (welfare, quotas, and so forth) for the economic
was made to account or control for other factors that downturn [78].
may matter to rumors about HIV/AIDS. Next,
participant truthfulness is a persistent issue in all self- Two notable contributions of this study center on
reported information. However, if there was one education and psychological well-being. Interestingly,
litmus test on the veracity of the responses it was educational level made a difference in the 2010/2011
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J Health Care and ResearchCitation: Parsons S. HIV Beliefs Among African Americans with HIV/AIDS in the Deep South Can Time Heal Old
Wounds? J Health Care and Research. 2021 May 11;2(2):70-84.
Original Article
sample only. Thus, time coupled with education may This current study joins the body of literature that
matter to the intensity of HIV rumors. Higher differentiates between benign neglect beliefs and
education and greater cognitive skepticism may act as malicious intent beliefs. Credit goes to the original
a counterweight to the skepticism inherent in fieldwork of Patricia Turner [4] and her research on
conspiracy beliefs [79]. Similarly, Zekeri et al. [52], in these beliefs among African Americans. Since Turner’s
their 2009 study of HIV+ individuals in a Deep South [4] pioneering research, other relatively dated studies
state, found that greater education was related to have noted a distinct difference between malicious
reduced HIV conspiracy beliefs. In contrast to the intent and benign intent theories [25,31]. Adopting
author’s study, a sizable percentage of the respondents wording from Van Deburg [85], benign intent theories
in the Zekeri et al. [52] survey believed that AIDS was can be viewed among skeptical African Americans,
a form of genocide of African Americans (31%) and without judgement, as “suspicion over fear”. While
that government was responsible for producing the responses to conspiracy beliefs can range from
virus (43,1%) but not necessarily with the intention of “healthy skepticism to debilitating paranoia” [85], the
controlling Black Americans (29%). In that study, the sustainability of benign neglect beliefs is by no means
benign neglect beliefs were much more readily evidence of debilitating paranoia but healthy
believed than the malicious intent beliefs; for example, skepticism. In the middle of this Covid-19 pandemic,
a majority agreed (70%) that government was African American men worry about increased police
withholding information and a cure (56%) [52]. harassment if they wear masks as mandated [86].
Interestingly, distrust in the HIV health care system, That fear is undoubtedly stronger in Louisiana with
governmental or private, may or may not equate to the criminal justice system still defined by slavery [87].
distrust in the providers of those services [80,81]. As indicated earlier in this study, racial discrimination
in Louisiana remains etched as an indelible reality of
Other studies, which are not specific to HIV, have being African American in the Deep South, even
hypothesized that malicious-intent conspiracy beliefs contributing to the high HIV rates in the state [88].
are related not only to education but to psychological
factors as well [82]. The results of both data sets in the In closing, there are a few recommendations beyond
current study suggested that psychological well-being the suggestion to update this study. First, there is an
is related to malicious intent rumors. Prior research absolute paucity of current studies on HIV malicious
indicates that health and treatment decisions can be versus benign beliefs among African Americans despite
affected by conspiracy beliefs, feelings of the value of such research. The scholarly literature, in
powerlessness [83] as well as a distrust of power [84]. the last five years, might have moved forward to other
“conspiracy” belief topics, for example, the motivation
The most noteworthy result of this study is the to think critically and cognitive ability [89] as well as
decline in the intensity of the belief in malicious intent political and social contributors [90], while the
from one decade to the next. The more sustainable circumstances of and knowledge about the beliefs of
rumor was the distrust in government to be truthful – African Americans in the Deep South has barely inched
a benign-neglect belief. As stated earlier, benign- forward.
neglect beliefs can be more resilient and may indicate a
generalized suspicion of the motives of government. Second, this author suggests that more emphasis be
While the findings should be considered only placed on systematic reviews of the studies on rumors
provocative because of the noted weaknesses, even so, and medical decision-making among African
this study makes a novel and significant contribution Americans to allow future research to fill the gaps
in attempting to respond to the question: Does time identified. How are these beliefs measured? How is
matter to the intensity of HIV beliefs among African medical decision-making assessed? In terms of benign
Americans? The results suggest that time may matter distrust of government, what questions are asked to
but not equally across rumors. identify distrust or suspicion? This point is important
considering that there may be great trust of the
Manuscript no: JHCR-2-70 Volume: 2 Issue: 2 77
J Health Care and ResearchCitation: Parsons S. HIV Beliefs Among African Americans with HIV/AIDS in the Deep South Can Time Heal Old
Wounds? J Health Care and Research. 2021 May 11;2(2):70-84.
Original Article
providers of HIV services despite pronounced health care entities need to address the distrust of
suspicion of American institutions, such as the health African Americans [36,46,99-106] dispel conspiracies
care system [81]. Thus, a question such as government [28,30,107] be sensitive to those believers [108] and
is telling the truth about HIV/AIDS begs the question – remember the stigma attached to the disease [109,110].
which government is the respondent mentally This author agrees and suggests that the change in
picturing to answer that question? messaging should begin with future researchers
sparingly using the stigmatized/stereotyped word –
Third, future studies can assess if any difference in conspiracy, in HIV/AIDS research of communities-of-
the intensity of HIV rumors is a lag in time or color. If we view this body of research through the
education or both. Investigating the contributing “insider” lens of public health critical race theorists
factors to these beliefs, as well as determining if these [111-113] our mindful messaging as researchers can be
beliefs matter to HIV treatment decisions, would add a the “praxis between research and practice” [111].
significant contribution to this field of literature. This
study could not add that contribution through any Funding
methodological manner, although at face value HIV This study did not receive any specific grant from
rumors did not appear to be a consideration in the funding agencies in the public, commercial, or not-for-
(self-reported) timing of treatment. This profit sectors. The only funding for this study was for
recommendation would likely be of the greatest benefit the gift-card incentives for the participants. No other
to investigate because of the continuing academic funding was received for this study.
debate about the potency of HIV beliefs in testing,
treatment or research participation decisions Compliance with Ethical Standards
[31,52,91,92]. Interestingly, two studies of conspiracy The research was approved by the University
beliefs among HIV+ African Americans in care for the Institutional Review Board.
disease found that HIV conspiracy beliefs were
common [45,52], but these individuals were still
Acknowledgements
receiving HIV medical care despite anecdotal
Thanks goes to William Simmons, PhD and
information of stockpiling or selling medications, for
Genomary Krigbaum-Pérez, PsyD for their valuable
example [45]. These studies exemplify the lingering
support. My humble gratitude is extended to every
question: what role, if any, do these HIV-related beliefs
individual participating in these surveys. Thank you
play in medical care decision-making?
for the honor of allowing me to give voice to your
words.
Finally, this author joins Jaiswal et al. [93] with a
suggestion to rethink the common use of conspiracies
in terms of HIV beliefs. The framing of the message as Competing Interests
a conspiracy, rather than HIV beliefs, may be a The author has read and approved the final version
disservice to prevention and treatment efforts as well of the manuscript. The author has no conflicts of
as to discount the lived experiences of Black interest to declare.
Americans, the historic racism and cause for distrust.
It takes little imagination, as other authors References
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