Study: Minorities less likely to participate in AIDS drug research

Wednesday, May 1st 2002, 12:00 am
By: News On 6

Minorities account for nearly half of all Americans infected with HIV but are less likely than whites to be included in research on new AIDS drugs, a study shows.

The researchers found there was usually no difference in participation between men and women in such research.

Earlier studies have suggested minorities, as well as women, were underrepresented in AIDS research, mirroring studies that show racial differences in health care for a host of diseases. The study in Thursday's New England Journal of Medicine looked at a nationwide sample of patients under care for HIV.

Researcher Dr. Allen Gifford noted HIV infections are growing most rapidly among minorities and in poorer, less-educated communities.

``If African-Americans and Hispanics aren't adequately represented in our clinical trials, don't have access to our experimental medications, that's a major concern,'' said Gifford, of the Veteran Affairs San Diego Healthcare System and the University of California, San Diego.

Fewer than half as many black patients as white patients tried to get experimental AIDS drugs, which the researchers said suggested ``there is less awareness and a more widespread negative attitude about research in minority communities.'' Study participants are usually referred by doctors or seek out studies themselves.

Gifford said it's important to include racial and ethnic groups to find out if drugs are metabolized differently or have different side effects. Participants also have access to alternative treatments and care they might not get otherwise, he said.

The two-year study surveyed 2,864 HIV patients three times beginning in 1996, two years after the government issued guidelines for including women and minorities in research.

Overall, 14 percent of the patients were taking part in research at the time, while 24 percent had either been in studies or received experimental drugs at some point during treatment. Eight percent said they had tried but couldn't get experimental drugs.

Blacks and Hispanics were about half as likely as whites to be in a study or to have received experimental treatment at any point. Gifford said the differences persisted when the patients had similar insurance, education or seriousness of illness.

Among the findings, whites accounted for 49 percent of HIV infections and 62 percent of study participants; blacks were 33 percent of HIV cases and 23 percent of those in studies and Hispanics, 15 percent and 11 percent.

Researchers said one reason black patients may not participate is a general suspicion about research stemming from the 1930s Tuskegee experiment _ in which government doctors let black men in an Alabama county go untreated for syphilis _ or from beliefs that HIV itself is a government plot or experiment.

Gifford said moving more treatment centers into minority communities could help increase participation. The study showed distance from treatment sites affected enrollment.

Dr. Talmadge E. King Jr. of San Francisco General Hospital suggested that racial prejudices and stereotypes in health care help create an atmosphere of mistrust and contribute to lower minority enrollment.

``The scientific and health care communities must continue aggressive efforts to educate patients with HIV infection about clinical trials and to motivate and encourage them to participate in such trials,'' King wrote in an accompanying editorial.