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. 2017 Jul 15;65(2):324-327.
doi: 10.1093/cid/cix313.

US Black Women and Human Immunodeficiency Virus Prevention: Time for New Approaches to Clinical Trials

Adaora A Adimora  1   2 , Stephen R Cole  2 , Joseph J Eron  1   2
Affiliations

US Black Women and Human Immunodeficiency Virus Prevention: Time for New Approaches to Clinical Trials

Adaora A Adimora et al. Clin Infect Dis. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Clin Infect Dis. 2019 Jan 18;68(3):534. doi: 10.1093/cid/cix1078. Clin Infect Dis. 2019. PMID: 29788307 Free PMC article. No abstract available.

Abstract

Black women bear the highest burden of human immunodeficiency virus (HIV) infection among US women. Tenofovir/emtricitabine HIV prevention trials among women in Africa have yielded varying results. Ideally, a randomized controlled trial (RCT) among US women would provide data for guidelines for US women's HIV preexposure prophylaxis use. However, even among US black women at high risk for HIV infection, sample size requirements for an RCT with HIV incidence as its outcome are prohibitively high. We propose to circumvent this large sample size requirement by evaluating relationships between HIV incidence and drug concentrations measured among participants in traditional phase 3 trials in high-incidence settings and then applying these observations to drug concentrations measured among at-risk individuals in lower-incidence settings, such as US black women. This strategy could strengthen the evidence base to enable black women to fully benefit from prevention research advances and decrease racial disparities in HIV rates.

Keywords: HIV and racial disparities; HIV epidemiology and African Americans; HIV prevention; black women and HIV prevention; clinical trial designs.

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References

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