Provider Attitudes Regarding Participation of Women and Persons of Color in AIDS Clinical Trials

Abstract

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.

Evaluating Acceptance and Understanding of Risk in the Emergency Department:Are All Risk Statements Created Equally?

“…[12][13][14][15][16][17] Our results are consistent with these findings, indicating that subjects who were nonwhite, of lower educational level, and of younger age were less likely to accept research risk, even in a mock study format. The lower participation rates observed for these populations may in part reflect a general lack of trust in biomedical research.…”

“…18 Other factors, including barriers to participation and provider attitudes toward such populations, may contribute to disparities in research participation rates. 13 It is interesting that such differences were demonstrated even in our mock trial format.…”

System and Patient Barriers to Appropriate HIV Care for Disadvantaged Populations: The HIV Medical Care Provider Perspective

“…Whether these perceptual differences translate into barriers to care for disadvantaged HIV patients was not directly evaluated in this study, although several studies have linked HIV care providers' perceptions and attitudes as detrimental to minorities in the critical issues of prescription of highly active antiretroviral therapy and inclusion in AIDS clinical trials (Bogart, Kelly, Catz, & Sosman, 2000;Gifford et al, 2002;Stone, Mauch, & Steger, 1998). It is therefore urgent that there be better understanding of cross-cultural interactions between patients and providers in the HIV/ AIDS care field and that providers in this field support and participate in cultural competency training.…”

South Asian participation in clinical trials: The views of lay people and health professionals

“…'Not being approached to participate in clinical trials' was a common perception in the three sub-groups. Similarly, the literature highlights that ethnic minority people may not be asked to participate in clinical trials [30,31]. The interviews with health professionals echoed this sentiment since nearly a quarter of the respondents did not think that representational sampling was important and that it was preferable to have trials specifically designed for illnesses prevalent among people of South Asian origin.…”

“…Health professionals have been shown to hold stereotypes on the basis of ethnicity [31][32][33], in which the experiences of minority ethnic populations are misrepresented and associated with 'deviance' and 'pathology'. We now explore these in greater detail.…”