HIV-1–Specific CD4 Helper Function in Persons With Chronic HIV-1 Infection on Antiviral Drug Therapy as Measured by ELISPOT After Treatment With an Inactivated, gp120-Depleted HIV-1 in Incomplete Freund's Adjuvant

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Abstract
Background:Although African Americans are disproportionately affected by the AIDS epidemic, they are underrepresented in AIDS research, particularly in AIDS clinical trials. This study examines a multidimensional construct of distrust and other factors that may affect willingness to participate in AIDS research. Methods:A total of 301 African Americans (aged ≥18 years) in Durham, North Carolina participated in a cross-sectional survey. In-person interviews, 20 to 25 minutes in length, were conducted with participants. Structural equation modeling was used to develop models exploring distrust and other factors affecting willingness to participate in AIDS research among African Americans. Results:Distrust was the strongest inverse predictor of willingness to participate in AIDS clinical trials. Distrust was not significantly associated with willingness to participate in AIDS surveys and educational interventions. Altruism, facilitators/ barriers, religiosity, and economic group membership were also significantly associated with willingness to participate in AIDS clinical trials. Only altruism was significantly associated with willingness to participate in AIDS surveys and educational interventions. Conclusions:Distrust about research institutions is a significant barrier to recruiting African Americans in AIDS clinical trials. Issues of distrust need to be acknowledged by researchers to develop better recruitment and retention strategies when conducting AIDS clinical trials in African-American communities. Address correspondence and reprint requests to Sohini Sengupta at Center for AIDS Prevention Studies, University of California, San Francisco, 74 New Montgomery, Suite 600, San Francisco, CA 94105, U.S.A.; email: [email protected] This study was part of a doctoral dissertation completed within the Department of Health Behavior and Health Education, School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Manuscript received January 10, 2000; accepted April 26, 2000. © 2000 Lippincott Williams & Wilkins, Inc.

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