Intervention Remedies Racial Disparities in HIV Research

In a recent issue of AIDS and Behavior, researchers from the New York University College of Nursing (NYUCN) and the National Institutes of Health (NIH) addressed the underrepresentation of HIV-positive African Americans and Hispanics in scientific studies.

While half of all HIV/AIDS patients are African American, they only comprise 30% of those enrolled in clinical trials on the disease, according to an NYUCN press release. Similarly, Latino patients are underrepresented in scientific research on HIV/AIDS.

With the goal to analyze and weigh “the efficacy of a social/behavioral intervention to increase rates of screening for and enrollment into HIV/AIDS medical studies (HAMS) in these populations,” the investigators recruited 540 participants for a cluster randomized controlled trial.

In addition to participating in 6-hour intervention sessions called ACT2, the subjects received individual assistance throughout the eligibility screening process. To increase the influence of the ACT2 intervention, those enrolled were encouraged to educate their peers about medical studies. According to the researchers, success was defined as a patient screening and subsequently enrolling in a therapeutic/treatment-oriented or observational study.

Compared to the control subjects who did not undergo ACT2, “intervention arm participants were 30 times more likely to be screened than controls,” the authors found. Furthermore, 55.5% of those screened were determined to be eligible for a HAMS, especially an observational one. Although no eligible controls enrolled in an observational study, 91.7% of eligible ACT2 participants did so.

In light of the findings, Marya Gwadz, a senior research scientist at NYUCN and the study’s lead author, claimed the belief that African American and Latino communities are apathetic to HIV/AIDS research is a misconception.

“We found that members of these groups are typically fearful of medical studies and also have socioeconomic barriers to accessing them,” Gwadz commented. “Yet, we found that in the context of the ACT2 intervention program — which allows participants to learn more about trials, articulate these fears, and gain access to trials — they are very willing to explore the possibility of participating, and if they are found eligible and the study is right for them, also eager to enroll.”

While under-representation of African Americans and Latinos in HIV/AIDS research is a known problem, increasing minority participation requires a multifaceted solution, Gwadz said. Nevertheless, she touted her study as the first to test the success of behavioral and social intervention methods to decrease low participation rates among minorities.

“Achieving appropriate representation of African American/Black and Hispanic persons living with HIV/AIDS in HAMS necessitates modification of study inclusion criteria to increase the proportion found eligible for therapeutic HAMS, in addition to social/behavioral interventions,” the authors concluded.