Environmental Factor, March 2008, National Institute of Environmental Health Sciences
Exploring the Impact of HIV/AIDS on African American Women
By Eddy Ball
Along with plenty of straight talk about the impact of HIV/AIDS on African American women, the audience at the NIEHS Black History Month Observance February 29 in Rodbell Auditorium heard a series of speakers who argued for greater participation of African Americans in clinical trials. Sponsored by the NIEHS Office of Clinical Research and the RTP Chapter of Blacks In Government (BIG), the event featured four women involved in the prevention and treatment of patients with HIV/AIDS and related diseases.
The program opened with a moving choral presentation of James Weldon Johnson's "Lift Every Voice and Sing," led by NIEHS Stem Cell Biologist and BIG member Annette Rice. NIEHS Project Officer and President of the RTP Chapter of BIG Veronica Godfrey welcomed the audience to the annual program on health disparities in the African American community. Rice introduced the panelists and gave an overview of the program.
In the first presentation, North Carolina Central University Professor La Verne Reid, Ph.D., surveyed the history of HIV/AIDS in the United States, risk factors for the disease and trends of new infections. She pointed to the disparity in the African American community, which makes up 13 percent of the population but 50 percent of new cases.
Reid introduced a theme that would be echoed by speakers throughout the event: the need to overcome complacency about HIV/AIDS, to engage in honest dialogue with sex partners, to practice safe sex and to get tested routinely - and re-tested as often as necessary. "HIV testing should be as normal as taking your temperature," she said.
Testing of a related kind was the topic of a talk by North Carolina Department of Health and Human Services Nurse Consultant Elizabeth Zeringue, a specialist in tuberculosis (TB) and TB/HIV co-infection. Zeringue tries to combat widespread complacency and ignorance about TB, which she said kills someone somewhere in the world every 20 seconds. "HIV dramatically increases the risk of tuberculosis when a person is co-infected," Zeringue told the audience.
Director of the Maria Parham Medical Center and Infectious Disease Specialist Michelle Collins Ogle, M.D., took consideration of the disease a step farther to include African American patients treated at her rural clinic, people who cope with HIV/AIDS every day of their lives. Ogle focused on the barriers to their participation in clinical trials, including a long history of medical abuse of minorities. One of the main reasons minorities don't get involved in clinical trials, she concludes, is "they don't trust the government."
To underscore the effects of health disparity, Ogle presented the dramatic differences in rates of treatment/participation in clinical trials by HIV/AIDS patients who are African American, 33 percent/21 percent; Hispanics, 15 percent/11 percent; and whites, 49 percent/62 percent.
The final panelist is a participant in an AIDS Clinical Trial at Duke University Medical Center, who was not identified to protect her rights to privacy and to comply with the Institutional Review Board stipulations governing her clinical trial. She explained her reasons for bucking her community's widespread distrust of the medical system by undergoing treatment and participating in clinical trials. Her narrative gave the audience an opportunity to hear a first-hand account of the experiences of an African American woman with HIV/AIDS. With her unaffected eloquence, the participant infused an emotional appeal into the program that reinforced the statistics presented by the rest of the panelists.
According to the participant, African Americans who volunteer for clinical trials not only help themselves by getting innovative treatments they would not get otherwise and increase the understanding of racially influenced differences in drug metabolism. As the participant explained, there are also other important reasons: "I just wanted to give back something to show my gratitude to the ones who went before me, to the people who marched and protested and, in other words, acted up."
The program concluded with a question-and-answer session and comments by NIEHS Clinical Research Unit Director Stavros Garantziotis, M.D., who expressed the support of Acting Director Sam Wilson, M.D., and Acting Clinical Director Darryl Zeldin, M.D., and reaffirmed his group's commitment to greater diversity in clinical research populations.