Minorities Less Likely to Be in HIV Trials; Study Finds Divide in Treatment Access

Black and Hispanic patients infected with HIV are less likely than whites to participate in clinical studies of new treatments or to receive experimental drugs, according to the first study that has used nationally representative data to examine such disparities. The report is published in today's edition of the New England Journal of Medicine (2002;346;18:1373- 1382).

An estimated 14 percent of approximately 231,000 adults treated for HIV infection in 1996 participated in a clinical trial, and 24 percent had taken an experimental drug, according to the study. Only 4 percent of adults with cancer who are younger than 50 participate in clinical trials.

But the results suggest marked racial and ethnic disparities in access to experimental HIV treatment. Blacks make up 33 percent of adults receiving HIV care nationally, but constituted only 23 percent of clinical trial participants. Similarly, Hispanics made up 15 percent of HIV-infected patients, but only 11 percent of study participants. Whites, who represented 49 percent of adults receiving HIV care, accounted for 62 percent of participants in HIV trials.

"These differences were robust," said Allen L. Gifford of the Veterans Affairs San Diego Healthcare System, principal author of the study. "They were present even when patients were at equal levels of education, equal stages of disease... and [lived] at equal distances from clinical trial centers." There were no significant differences by gender in the likelihood of getting into trials, Gifford said.

The research team studied a nationally representative sample of 2,864 adults in the 48 contiguous states who were receiving care for HIV infection in 1996. They interviewed participants three times from 1996 to 1998, asking about their participation in studies, their use of experimental drugs and other personal data, including such factors as their trust of doctors and desire to participate in treatment decisions. The researchers found, in addition to being black and Hispanic, other factors reduced the likelihood of participating in a clinical trial, including having less than a high school education, belonging to an HMO and living eight or more miles from a major research hospital.

Back to other CDC news for May 2, 2002

Previous Updates