HIV-related ‘conspiracy beliefs’: lived experiences of racism and socio-economic exclusion among people living with HIV in New York City

HIV-related ‘conspiracy beliefs’ include ideas about the genocidal origin of HIV and the nature and purpose of HIV-related medications. These ideas have been widely documented as affecting myriad health behaviours and outcomes, including birth control use and HIV testing. Most HIV-related research has quantitatively explored this phenomenon, and further qualitative research is necessary to better understand the complexity of these beliefs as articulated by those who endorse them. Moreover, public health in general has over-emphasised the role of the Tuskegee Syphilis Study in explaining mistrust, rather than focus on ongoing social inequalities. Twenty-seven semi-structured interviews were conducted with low-income Black and Latinx people living with HIV who were currently, or had been recently, disengaged from HIV medical care. Beliefs about the role and intentions of the government and pharmaceutical industry in the epidemic highlighted the racism and classism experienced by participants. Notably, however, HIV care providers were not perceived as part of the government–pharmaceutical collusion. Interventions should focus on fostering positive beliefs about HIV medication and building trust between HIV care providers and populations that have experienced ongoing social and economic exclusion. Replacing the phrase ‘conspiracy beliefs’ with more descriptive terms, such as HIV-related beliefs, could avoid discrediting people’s lived experiences.