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Minorities Remain Underrepresented in HIV/AIDS Research Despite Access to Clinical Trials
Authors:Jose R Castillo-Mancilla  Susan E Cohn  Supriya Krishnan  Michelle Cespedes  Michelle Floris-Moore  Gail Schulte
Institution:1. University of Colorado-AMC, Aurora, Colorado;2. Northwestern University Feinberg School of Medicine, Chicago, Illinois;3. Center for Biostatistics in AIDS ResearchHarvard School of Public Health, Boston, Massachusetts;4. New York University School of Medicine, New York, New York;5. University of North Carolina School of Medicine, Chapel Hill, North Carolina;6. Social and Scientific SystemsSilver Spring, Maryland
Abstract:Background and Objective: The reasons for minority underrepresentation in HIV/AIDS clinical trials remain unclear. We aimed to evaluate the knowledge, experience, and factors that influence minority participation in HIV/AIDS studies in the United States. Methods: An anonymous, bilingual, self-administered survey on study participation was given to HIV-infected adults attending AIDS Clinical Trials Group–affiliated clinics in the United States and Puerto Rico. Chi-square tests were used to evaluate differences by race, first language, and level of education. Logistic regression was used to estimate odds ratio (OR) and 95% confidence interval (CI) for factors associated with being talked to about participation in a study. Results: We analyzed 2,175 complete surveys (221 in Spanish). Among respondents, 31% were White, 40% were Black/African American (AA), and 21% were Hispanic. The overall rate of previous participation in any HIV/AIDS study was 48%. Hispanics were less likely to know about studies compared to Whites and AAs (67% vs 74% and 76%, respectively; P .001). Compared to Whites, AAs and Hispanics were less likely to have been talked to about participating in a study (76% vs 67% and 67%, respectively; P .001). The OR for being talked to about participating in a study was 0.65 (95% CI, 0.52–0.81) for AAs and 0.65 (95% CI, 0.49–0.85) for Hispanics, compared to Whites. AAs and Hispanics were more likely to state that studies were not friendly to their race (17% and 10% vs 4%; P .001). Conclusions: Minorities continue to face barriers for HIV/AIDS trial participation, even when clinical research is available. Enrollment strategies should better target minorities to improve recruitment in HIV/AIDS research.
Keywords:AIDS  clinical trials  HIV  minority  research participation  underrepresented
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