REPRESENTATION MATTERS: THE IMPORTANCE OF HIV CLINICAL TRIAL DIVERSITY 

The history of controlled clinical trials extends back to 1747 with Dr. James Lind’s research into a cure for scurvy.1

Since that time, clinical trials have been at the heart of just about every medical advancement over the last 300+ years. While technology has advanced and our approaches have evolved, what has not changed is recognition of the importance of research to our understanding of how we prevent, diagnose, and treat disease. Nowhere is this truer than in the HIV space where, following the earliest efforts to prevent and treat the virus in the mid-1980s, research has transformed what was once considered a death sentence into what is now a manageable chronic condition.

One challenge that remains is a lack of diversity in clinical trials. Specifically, ensuring trials enroll patients that are representative of the general population or those affected by a specific disease. What the HIV epidemic and, more recently, the COVID-19 pandemic has underscored, is that communities of color and other underserved communities often bear the greatest burden of disease. However, healthcare professionals can find it challenging to apply the results of large research studies to their everyday practice when the study participants do not reflect the race, ethnicity, age, sex, or gender identity of their patients. We need to take action to ensure that we are increasing diversity in clinical trials and, more broadly, effecting long-lasting change to reduce biases, promote social justice, and improve health equity for these individuals.

“Across the globe, there’s a lack of diversity in clinical trials,” said Tammeka Evans, DHSc, Senior Director of Global Public Health and Innovation at ViiV Healthcare. “In the U.S., for example, Blacks and Hispanics make up 65% of all HIV cases, yet they represent less than half of all participants in HIV clinical trials. Diversity in clinical trials is so important because we want to ensure that those who are most impacted by HIV in any region of the world can benefit from the resources, research and development, and real-world implementation of the HIV innovation we have to offer at ViiV Healthcare.”

Our work to prioritize the groups most affected by HIV includes focusing on improving clinical trial recruitment, engagement, and retention to ensure trials mirror the diverse populations we serve. One way we are building trust and elevating ViiV Healthcare’s commitment to overcoming the disparities that have come to define the HIV epidemic is through local External Affairs Community Liaisons. This team actively engages with communities to better understand their needs so we can continue to address them. By engaging and partnering with these often-marginalized populations, we hope to improve their trust in the scientific community and, ultimately, improve participation in clinical trials.

ViiV Healthcare is also working to increase the awareness and emphasis on diversity in HIV research through our Research and Development Diversity Task Force. This task force focuses on addressing under-representation of key groups in HIV clinical trials. We believe that continued advocacy for representation is critical to ensuring equity, not only in our research but in access to our innovative therapies.

Hear more from Dr. Evans on how we’re working to accomplish this.

Reference:

  1. Bhatt A. Evolution of clinical research: a history before and beyond James Lind. Perspect Clin Res. 2010;1(1):6-10.