A Critical Review of African American’s Recruitment in HIV/AIDS Clinical Trials: Why Sociostructural Context Matters

Abstract

Despite being the racial/ethnic group that is disproportionately affected by HIV/AIDS, African Americans are underrepresented in HIV/AIDS clinical trials. The reasons for the inadequate participation of African Americans in HIV/AIDS clinical trials are multidimensional, consisting of individual, investigator, study-related, and structural factors, all of which are shaped by larger social, economic, and political forces. In order to comprehensively address the factors that influence African Americans participation in HIV/AIDS clinical trials and move towards reducing the racial disparity in HIV/AIDS clinical trials participation, the biomedical, clinical trials research approach needs to locate individuals and their decision to participate within the larger sociostructural context in which individuals and their decision to participate exist. Incorporating intersectionality, cultural competency, and structural competency into the training of researchers, increasing community involvement in the research process, and increasing the representation of minority researchers on research teams can help clinical researchers learn how to locate individuals within their broader sociostructural contexts so that they can learn how to navigate the multidimensional factors that influence African Americans’ decision to participate in HIV/AIDS clinical trials.