Race, gender, drug use, and participation in AIDS clinical trials. Lessons from a municipal hospital cohort.
OBJECTIVE
To determine whether participation rates of women, persons of color, and injection drug users in AIDS clinical trials are similar to those of other HIV/AIDS patients, and to examine whether differences in patients' knowledge of clinical trails or reasons for not participating explain differences in participation rates by gender, race, or drug use.


METHODS
Cross-sectional survey of patients with HIV disease.


METHODS
Ambulatory practice of a municipal teaching hospital.


METHODS
Two hundred sixty patients receiving primary care for HIV disease.


RESULTS
Overall, 22.3% of patients had participated in a clinical trail. Women, patients of color, and drug users were significantly less likely to have ever participated in an AIDS clinical trial (p < .05). Multiple logistic regression confirmed being a person of color (odds ratio [OR] 2.14; 95% confidence interval [CI] 1.12-4.08) and injection drug use (OR 2.09; 95% CI 1.08-4.04) as significant predictors of nonparticipation in AIDS clinical trials (p < .05). Patients of color and women reported less knowledge of clinical trials, and were less likely to have been told about clinical trials for which they were eligible (p < .05). Patients of color were half as likely as whites to cite ineligibility as their reason for not participating (10.4% vs 22.4%). and more likely to hold unfavorable opinions of clinical research (50.7% vs. 40.5%). Reasons for nonparticipation did not differ by gender.


CONCLUSIONS
Even when AIDS clinical trials are available on-site, persons of color, women, and drug users are less likely to participate. Educational efforts for patients and providers are needed to remedy continuing disparities in participation by race, gender, and risk factor group in AIDS clinical trials.
Stone
V E
VE
Section of General Internal Medicine, University School of Medicine, Boston, MA, USA.
Mauch
M Y
MY
Steger
K
K
Janas
S F
SF
Craven
D E
DE
D000163:Acquired Immunodeficiency Syndrome / Q000628:therapy*; D001900:Boston; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004608:Eligibility Determination; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006773:Hospitals, Municipal; D006801:Humans; D008913:Minority Groups / Q000706:statistics & numerical data*; D010358:Patient Participation / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders; D014930:Women