Article
HIV-infected African Americans are willing to participate in HIV treatment trials.
Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Journal of General Internal Medicine (impact factor:
2.83).
02/2007;
22(1):17-42.
DOI:10.1007/s11606-007-0121-8
pp.17-42
Source: PubMed
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Citations (0)
- Cited In (1)
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Article: Comparative efficacy versus effectiveness of initial antiretroviral therapy in clinical trials versus routine care.
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ABSTRACT: The applicability of clinical trial findings (efficacy) to the routine care setting (effectiveness) may be limited because of study eligibility criteria and volunteer bias. Although well-chronicled in many conditions, the efficacy versus effectiveness of antiretroviral therapy (ART) remains understudied. A retrospective study of the University of Alabama at Birmingham 1917 Clinic Cohort evaluated ART-naive patients who started ART from 1 January 2000 through 31 December 2006. Patients received ART through clinical trials or routine care. Multivariable logistic and linear regression models were fit to evaluate factors associated with virological failure (virological failure was defined as a viral load >50 copies/mL) and change from baseline CD4+ cell count 6 and 12 months after ART initiation. Sensitivity analyses evaluated the impact of missing data on outcomes. Among 570 patients starting ART during the study period, 121 (21%) enrolled in clinical trials, and 449 (79%) received ART via routine care. ART receipt through routine care was not associated with viral failure at either 6 months (odds ratio [OR], 1.00; 95% confidence interval [CI], 0.54-1.86) or 12 months (OR, 1.56; 95% CI, 0.80-3.05) in primary analyses. No statistically significant differences in CD4+ cell count responses at 6 and 12 months were observed. Although marked differences in efficacy versus effectiveness have been observed in the therapeutic outcomes of other conditions, our analyses found no evidence of such divergence among our patients who initiated antiretroviral therapy for human immunodeficiency virus infection.Clinical Infectious Diseases 02/2010; 50(4):574-84. · 9.15 Impact Factor
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Keywords
200 HIV-infected African-American adults
actual participation rates
African Americans
African-American community
future HIV treatment trials
HIV infection
HIV treatment trial
HIV treatment trials
HIV-infected African Americans
major barrier
medical profession
Pittsburgh AIDS Center
previous studies
Questionnaire development
research participation
Research participation rates
researchers
sociodemographic characteristics
survey respondents
university-based ambulatory clinic