However, as the UCHCC comprises about 10% of all HIV-infected individuals in NC, it is probably representative of the HIV-infected population in NC. Moreover, six southeastern states (North Carolina, South Carolina, click here Mississippi, Alabama, Georgia and Louisiana) report demographically similar epidemics, supporting the generalizability of these results to the southeast USA [39–41]. The comparable rates of enrolment between Black and non-Black patients and between genders and those of different sexual orientations may partly be
attributed to the demographic make-up of the ID clinic and to the existing ACTG. Previous studies have shown that, compared with other ACTG sites, the UNC ACTG has high trial enrolment rates for racial/ethnic minorities,
and for women trial participation is associated with living in an area with an NIH- or CDC-supported research network [12,34]. In addition, NC has historically had strict eligibility criteria for the state-funded AIDS Drug Assistance Program (ADAP). Limited access to ADAP may leave participation in HIV treatment trials as the only option for access to ART. Finally, we recognize that several unmeasured variables, including work pressures, child-bearing wishes and vertical transmission UK-371804 issues, could have influenced our study results. In summary, in the clinical setting studied we achieved high rates of participation in HIV treatment trials. Gender did not appear to impact participation in HIV treatment trials but Black patients were slightly less likely to participate in these trials. We hypothesize that, in part, our results might be explained by guidelines and policies adopted both in the USA and in other countries to correct the imbalance DCLK1 in trial participation [15,42]. Considering the substantial proportion of HIV-infected patients who are Black, future
trials need to consider strategies to further incorporate underrepresented populations. Further investigation into the role of insurance in trial participation is needed. A continued exploration of barriers to clinical trial participation must consider other factors, including trust issues, awareness and information about clinical trials and trial characteristics. We thank Julius Atashili PhD for his assistance with editing this paper. We greatly appreciate the support of all the personnel involved in the conduct of the clinical trials and in the development and ongoing maintenance of the University of North Carolina (UNC) Center for AIDS Research (CFAR) HIV/AIDS clinical cohort, and that of the HIV care providers and staff of the UNC infectious diseases clinic. In particular, we thank the patients who participated in this study.