| Black and Hispanic patients infected with the HIV | | | | The research team studied a nationally representative |
| virus are less likely than whites to participate in clinical | | | | sample of 2 864 adults in the 48 contiguous United |
| studies of new treatments or to receive | | | | States who were receiving care for HIV infection in |
| experimental drugs, according to the first study that | | | | 1996. They interviewed participants three times |
| has used nationally representative data to examine | | | | between 1996 and 1998, asking about their |
| such disparities. Moreover, underrepresentation of | | | | participation in studies, their use of experimental |
| blacks and Hispanics in HIV treatment studies | | | | drugs and other personal data, including such factors |
| becomes a concern for the applicability of the clinical | | | | as their trust of doctors and desire to participate in |
| research to patients in the general population. | | | | decisions about treatment. The researchers found |
| The findings indicate that people with HIV infection | | | | that, in addition to being black or Hispanic, several |
| overall are much more likely to get experimental | | | | other factors also reduced patients' likelihood of |
| treatments than are people with other diseases, such | | | | participating in a clinical trial. They included having less |
| as cancer or heart disease. Because AIDS treatment | | | | than a high school education, belonging to a health |
| is evolving rapidly Links Of London and because the | | | | maintenance organization (HMO), and living eight or |
| virus often develops resistance to approved drugs, | | | | more miles from a major research hospital. Patients |
| AIDS activists have lobbied successfully to expand | | | | who were white, who were highly educated or who |
| access to new medicines. An estimated 14 percent | | | | received their health care close to a research center |
| of the approximately 231 000 adults treated for HIV | | | | were more likely than others to get experimental |
| infection in 1996 participated in a clinical trial, and 24 | | | | drugs. |
| percent had taken an experimental drug, the study | | | | In an editorial accompanying the study, Tallmadge E. |
| found. Only 4 percent of adults with cancer who are | | | | King of San Francisco General Hospital suggested that |
| less than 50 years old participate in clinical trials. | | | | racial and ethnic disparities in access to experimental |
| But the results suggest marked racial and ethnic | | | | treatment may reflect "barriers at the level of the |
| disparities in access to experimental HIV treatment. | | | | patient, the Links Of London Bracelets physician, the |
| Blacks made up only 23 percent of clinical study | | | | institution and the community. "Doctors may harbor |
| participants but constituted 33 percent of adults | | | | unconscious prejudices toward blacks or Hispanics, he |
| receiving HIV care. Similarly, 11 percent of study | | | | suggested. Patients may be mistrustful or fear that |
| participants, but 15 percent of HIV-infected patients | | | | participating in a study will threaten their autonomy. |
| nationally, were Hispanic. In contrast, whites made up | | | | Researchers studying new treatments for drug |
| 62 percent of participants in HIV trials, yet | | | | companies may avoid enrolling members of minorities |
| represented only 49 percent of adults receiving HIV | | | | "because they believe that poor compliance is |
| care. | | | | common in these groups". |