Castillo-Mancilla Jose R, Cohn Susan E, Krishnan Supriya, Cespedes Michelle, Floris-Moore Michelle, Schulte Gail, Pavlov Gregory, Mildvan Donna, Smith Kimberly Y
University of Colorado-AMC, Aurora, Colorado.
Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
HIV Clin Trials. 2014 Jan-Feb;15(1):14-26. doi: 10.1310/hct1501-14.
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.
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.
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).
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.
少数族裔在艾滋病临床试验中代表性不足的原因尚不清楚。我们旨在评估影响美国少数族裔参与艾滋病研究的知识、经验和因素。
对在美国和波多黎各参加艾滋病临床试验组附属诊所的感染艾滋病毒的成年人进行了一项关于研究参与情况的匿名、双语、自我管理的调查。采用卡方检验评估种族、母语和教育水平的差异。使用逻辑回归估计与被谈论参与研究相关因素的比值比（OR）和95%置信区间（CI）。
我们分析了2175份完整的调查问卷（221份为西班牙语）。在受访者中，31%为白人，40%为黑人/非裔美国人，21%为西班牙裔。之前参与过任何艾滋病研究的总体比例为48%。与白人和非裔美国人相比，西班牙裔了解研究的可能性较小（分别为67%对74%和76%；P < 0.001）。与白人相比，非裔美国人和西班牙裔被谈论参与研究的可能性较小（分别为76%对67%和67%；P < 0.001）。与白人相比，非裔美国人被谈论参与研究的OR为0.65（95% CI, 0.52 - 0.81），西班牙裔为0.65（95% CI, 0.49 - 0.85）。非裔美国人和西班牙裔更有可能表示研究对他们的种族不友好（分别为17%和10%对4%；P < 0.001）。
即使有临床研究，少数族裔在参与艾滋病试验方面仍然面临障碍。招募策略应更好地面向少数族裔，以改善艾滋病研究中的招募情况。
