Gender differences in attitudes toward AIDS clinical trials among urban HIV-infected individuals from racial and ethnic minority backgrounds

Abstract

Racial/ethnic minorities and women are under-represented in AIDS clinical trials (ACTs). We examined gender differences in willingness to participate in ACTs among urban HIV-infected individuals (N=286). Sixty percent of participants were male, and most were from racial/ethnic minority backgrounds (55% African-American, 34% Latino/Hispanic, 11% White/other). Knowledge of ACTs was poor. Males and females did not differ substantially in their distrust of AIDS scientists, or in barriers to ACTs. Almost all (87%) were somewhat or very willing to join ACTs. Females were less willing than males to join, including trials testing new medications or new medication combinations. Males and females differed in correlates of willingness to participate in ACTs. Despite long-standing barriers to medical research among minorities and women, willingness to participate was substantial, particularly for men, although the factors that might motivate them to join differed by gender. Women appeared more averse to trials involving new anti-retroviral regimens than men. Gender-specific outreach, behavioural intervention, and social marketing efforts are needed.

Acknowledgments

This study was supported by a grant from the National Institute of Allergy and Infectious Diseases (1UO1 AI 46370). We would like to thank the women and men who participated in the study, as well as Gricel Arredondo, Scott Barnett, Zachary Bregman, MD, Nancy Cotto-Laboy, Sherry Deren, Ph.D., Patrick Dolby, Anthony Diggs, Duane Ebesu, Nionne James-Pineda, Charles King, Joaquin Lara, Jacqueline Long, Karen Mahler, Psy.D., Ann Marshak, Marion Riedel, Ph.D., Amanda Ritchie, Darrell Wheeler, Ph.D, and Jonathan Kagan, Ph.D. We would also like to express our appreciation to the staff of Housing Works, the AIDS Service Center, and the Beth Israel AIDS Clinical Trials Unit, for their assistance with the project. The project is dedicated to the memory of Keith Cylar, Co-founder and Co-CEO of Housing Works (1958–2004). Mr. Cylar was also a study Co-Principal Investigator.