Representation of Latinos and Blacks in screening for and enrollment into preventive HIV vaccine trials in New York City |
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| Affiliation: | 1. Division of Infectious Diseases, Department of Medicine, Columbia University, College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA;2. ICAP, Columbia University, Mailman School of Public Health, 722 West 168th Street, Box 18, New York, NY 10032, USA;3. Department of Medicine, Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA;4. Division of Infectious Diseases, Department of Medicine, University of Colorado, 12700 E. 19th Avenue, Mail Stop B168, Aurora, CO 80045, USA;5. Public Health Solutions, 40 Worth Street, 5th Floor, New York, NY 10013, USA;6. Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA;1. Global Health Research Central of Central Asia, Columbia University School of Social Work, New York, NY, United States;2. University of California San Diego School of Medicine, San Diego, CA, United States;3. ICAP at Columbia University Mailman School of Public Health, College of Physicians and Surgeons, New York, NY, United States;1. Internal Medicine Residency Program, Ochsner Clinic Foundation, New Orleans, LA;2. Ochsner Cancer Institute, Ochsner Clinic Foundation, New Orleans, LA;3. The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA;1. ICAP at Columbia University, Mailman School of Public Health, New York, NY, USA;2. Weill-Cornell Medical College, New York, NY, USA;3. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA;1. Centre for HIV and STIs, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa;2. Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;3. Johns Hopkins University School of Medicine, Baltimore, MD, United States;4. Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;5. ICAP, Columbia University Mailman School of Public Health, New York, NY, United States;6. Gertrude H. Sergievsky Center, College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States;1. Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Observatory, South Africa;2. Division of Medical Virology, Department of Pathology, University of Cape Town and National Health Laboratory Services, Observatory, South Africa;3. ICAP at Columbia University, Mailman School of Public Health, Columbia University and College of Physicians and Surgeons, Columbia University, New York, NY;1. George Washington University, School of Public Health and Health Services, Washington, DC, USA;2. University of North Carolina School of Medicine and Gillings School of Global Public Health, Chapel Hill, NC, USA;3. Fred Hutchinson Cancer Research Center, Seattle, WA, USA;4. FHI 360, Durham, NC, USA;5. Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA, USA;6. Department of Biostatistics, University of Washington, Seattle, WA, USA;7. Harlem Hospital Center, New York, NY, USA;8. Mailman School of Public Health, Columbia University, New York, NY, USA;9. Johns Hopkins University School of Medicine, Baltimore, MD, USA;10. Emory University, Department of Medicine, Division of Infectious Diseases, Atlanta, GA, USA;11. National Institutes of Health, National Institute on Allergy and Infectious Diseases, Bethesda, MD, USA;12. Rutgers, New Jersey Medical School, Newark, NJ, USA |
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| Abstract: | IntroductionIn the United States, Latinos and Blacks are disproportionately affected by HIV/AIDS, but have been underrepresented in HIV vaccine trials. We assessed screening and enrollment of Blacks and Latinos for preventive HIV vaccine trials conducted in New York City, 2009–2012.MethodsA retrospective analysis was conducted among 18–50 year old men and transgender women screening for four preventive phase 1 and 2 HIV vaccine trials. Demographic, recruitment, and behavioral/medical eligibility data and outcome of screening were examined. To determine factors associated with enrollment, a multivariable logistic regression analysis was performed.ResultsAmong 6077 individuals who provided contact information, 2536 completed a phone pre-screen. 96 (1.6% of recruitment contacts) enrolled. Latinos were 35.7% of recruitment contacts, but 17.7% of those enrolled, whereas Blacks were 22.5% and 32.3%, respectively. Among all Latinos, nearly one third were excluded for being uncircumcised, an eligibility criterion for several studies. In multivariable analysis among potentially eligible potential participants, controlling for age and recruitment method, Latinos were less likely than Whites to enroll in a preventive HIV vaccine trial (aOR 0.52, 95% CI 0.28–0.95) whereas Blacks were as likely as Whites (aOR 0.99, 95% CI 0.59–1.67). Individuals recruited through print advertisements, social media/internet, referral, and other modes were more likely to enroll compared to those recruited through in-person outreach, controlling for age and race/ethnicity.ConclusionsTargeted outreach has led to substantial inclusion of Latinos and Blacks, with Blacks comprising almost a third of those enrolled in these preventive HIV vaccine trials. Latinos, however, were less likely to enroll compared to Whites. Circumcision status as an eligibility criterion partly accounts for this, but further studies are warranted to address the reasons Latinos decide not to participate in preventive HIV vaccine trials. |
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| Keywords: | Preventive HIV vaccine Racial/ethnic disparities |
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