RESUMEN
AIDS clinical trials (ACTs) are critical to the development of new treatments for HIV infection. However, people of color living with HIV/AIDS are involved in ACTs at disproportionally low rates, with African-Americans experiencing the greatest under-representation. In this article, we describe the core elements and key characteristics of a highly efficacious multi-component peer-driven intervention (PDI) designed to increase rates of screening for and enrollment into ACTs among African-American and Latino/Hispanic individuals, by addressing the main complex, multi-level barriers they experience to ACTs. We discuss the process of developing the intervention, the theoretical models guiding its delivery format and content, and provide an overview of the intervention's components. We then use brief case studies to illustrate a number of key issues that may arise during intervention implementation. Finally, we describe lessons learned and provide recommendations for the PDI's uptake in clinical and clinical trials settings.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Negro o Afroamericano/psicología , Ensayos Clínicos como Asunto/psicología , Conocimientos, Actitudes y Práctica en Salud/etnología , Hispánicos o Latinos/psicología , Selección de Paciente , Síndrome de Inmunodeficiencia Adquirida/diagnóstico , Síndrome de Inmunodeficiencia Adquirida/etnología , Negro o Afroamericano/educación , Negro o Afroamericano/estadística & datos numéricos , Actitud del Personal de Salud , Ensayos Clínicos como Asunto/normas , Ensayos Clínicos como Asunto/estadística & datos numéricos , Miedo/psicología , Femenino , Hispánicos o Latinos/educación , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Masculino , Tamizaje Masivo/psicología , Educación del Paciente como Asunto/métodos , Navegación de Pacientes/métodos , Navegación de Pacientes/organización & administración , Grupo Paritario , Sesgo de Selección , Confianza/psicologíaRESUMEN
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.