OBJECTIVES: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 trials or reasons for not participating explain differences in participation rates by gender, race, or drug use. DESIGN: HIV infection and AIDS 1 are having an increasing impact on mortality and quality of life for women and persons of color in the United States. [2][3][4] In 1995, the AIDS incidence rate among blacks and Latinos was more than six times and two times, respectively, the rate among whites in the United States. 4 The incidence of AIDS is also increasing more rapidly among women than men; AIDS is now the third leading cause of death for all U.S. women aged 25 to 44 years. 2,5 This disease is increasingly afflicting women from all U.S. communities, but there has been a disproportionate increase in the prevalence of AIDS among minority women, particularly African Americans, Latinas, and Caribbean blacks. Women from communities of color together have accounted for nearly 76% of all reported cases of AIDS in women, while these groups represent only 21% of the general population of U.S. women. 2,5 And notably, the most common route of HIV acquisition among both women and persons of color diagnosed with AIDS to date has been injection drug use. 5 Despite their growing representation among AIDS cases, women, racial or ethnic minorities, and injection drug users have generally been underrepresented in clinical trials of drugs for the treatment of AIDS and early HIV disease. 6-10 To date, most clinical trials of treatment for HIV and HIV-related complications have been composed primarily of homosexual white men, with low participation of women, persons of color, and injection drug users. [6][7][8][9][10] Failure to include adequate numbers of women and persons of color may limit the generalizability and usefulness of study results for clinical practice. Furthermore, these subpopulations of HIV-infected individuals-women, persons of color, and injection drug users-have not had the benefit of early access to new treatments and prophylaxis for HIV and its complications that clinical trials have provided for participants. [6][7][8][9][10][11][12] It has been hypothesized that the lower participation of women, persons of color, and drug users primarily reflects impaired access to trials, due to several factors. Most initial AIDS Clinical Trials Units (ACTUs) were in centers that cared for few minorities, women, or drug users with HIV 8-10 ; and until recently, AIDS clinical trials have had restrictive eligibility criteria for women and injection drug users. 11,[13][14][15] Finally, minority patients, especially African Americans, may avoid participation in clinical trials because of suspicions about medical research resulting from a legacy of past studies that misused subjects. 8,10,16,17 Currently, there is little information about the relative rates of participation ...

OBJECTIVES: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 trials or reasons for not participating explain differences in participation rates by gender, race, or drug use. DESIGN: HIV infection and AIDS 1 are having an increasing impact on mortality and quality of life for women and persons of color in the United States. [2][3][4] In 1995, the AIDS incidence rate among blacks and Latinos was more than six times and two times, respectively, the rate among whites in the United States. 4 The incidence of AIDS is also increasing more rapidly among women than men; AIDS is now the third leading cause of death for all U.S. women aged 25 to 44 years. 2,5 This disease is increasingly afflicting women from all U.S. communities, but there has been a disproportionate increase in the prevalence of AIDS among minority women, particularly African Americans, Latinas, and Caribbean blacks. Women from communities of color together have accounted for nearly 76% of all reported cases of AIDS in women, while these groups represent only 21% of the general population of U.S. women. 2,5 And notably, the most common route of HIV acquisition among both women and persons of color diagnosed with AIDS to date has been injection drug use. 5 Despite their growing representation among AIDS cases, women, racial or ethnic minorities, and injection drug users have generally been underrepresented in clinical trials of drugs for the treatment of AIDS and early HIV disease. 6-10 To date, most clinical trials of treatment for HIV and HIV-related complications have been composed primarily of homosexual white men, with low participation of women, persons of color, and injection drug users. [6][7][8][9][10] Failure to include adequate numbers of women and persons of color may limit the generalizability and usefulness of study results for clinical practice. Furthermore, these subpopulations of HIV-infected individuals-women, persons of color, and injection drug users-have not had the benefit of early access to new treatments and prophylaxis for HIV and its complications that clinical trials have provided for participants. [6][7][8][9][10][11][12] It has been hypothesized that the lower participation of women, persons of color, and drug users primarily reflects impaired access to trials, due to several factors. Most initial AIDS Clinical Trials Units (ACTUs) were in centers that cared for few minorities, women, or drug users with HIV 8-10 ; and until recently, AIDS clinical trials have had restrictive eligibility criteria for women and injection drug users. 11,[13][14][15] Finally, minority patients, especially African Americans, may avoid participation in clinical trials because of suspicions about medical research resulting from a legacy of past studies that misused subjects. 8,10,16,17 Currently, there is little information about the relative rates of participation ...

Provider attitudes and perceptions that may influence recruitment and enrollment of diverse patients into AIDS clinical trials were examined by conducting a cross-sectional survey of all HIV/AIDS providers at a municipal teaching hospital. Providers were less likely to feel confident explaining trials to non-English-speaking patients (p < .05). Providers also reported being more confident of their ability to give an overview of clinical trials in culturally appropriate terms to white patients than to patients of other races/ethnicities (p < .05). Many providers perceived the interest in clinical trials by African American (25%), Latino (14%), and Haitian patients (30%) to be lower; and primarily cited suspicions about clinical research as the reason. Some providers (13%) perceived that women with HIV/AIDS are less interested in clinical trials. Despite these perceptions, all providers reported that they are just as likely to inform women and African Americans about available clinical trials; a small proportion reported that they were less likely to inform Latinos (6%) and Haitians (11%). None of these findings differed significantly by provider race, gender, HIV experience, languages spoken, or specialty. Underrepresentation of minorities and women in AIDS Clinical Trials may partially result from attitudes and perceptions of providers.

Introduction Little is known about herb use among underserved postpartum women and their patterns of communication about herb use with prenatal providers. Methods We interviewed women from the postpartum unit at an urban hospital about herb use during pregnancy, socioeconomic factors, prenatal vitamin use, and diet. We asked women if they discussed use of herbs and vitamins with their prenatal care provider, and their satisfaction with these discussions. We reviewed inpatient chart medication lists for herb use. Results Of 160 women surveyed, 39% reported using herbs during pregnancy. Sixty five percent of subjects took a prenatal vitamin. Fifty-seven percent of herb users (n=40) reported taking prenatal vitamins. Herb users were significantly more likely to report making any dietary change during their pregnancy than non-herb users (P=0.03). Only 38% of herb users discussed it with their prenatal provider and 82% were satisfied with the conversation. Of all 160 subjects, 125 had prenatal vitamin use documented and no women had herbal medicine use documented in the medical record during their delivery hospitalization. Discussion We report a higher frequency of herb use during pregnancy than other studies. The fact that women of all backgrounds and economic status report using herbs during pregnancy makes it even more important for all women to be asked about their use of herbs.

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