Considerations for Increasing Racial, Ethnic, Gender and Sexual Diversity in HIV Cure-Related Research with Analytical Treatment Interruptions: A Qualitative Inquiry

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Citation

Dube, Karine; Kanazawa, John T.; Campbell, Chadwick; Boone, Cheriko A.; Maragh-Bass, Allysha C.; Campbell, Danielle M.; Agosto-Rosario, Moises; Stockman, Jamila K.; Diallo, Dazon Dixon; & Poteat, Tonia, et al. (2022). Considerations for Increasing Racial, Ethnic, Gender and Sexual Diversity in HIV Cure-Related Research with Analytical Treatment Interruptions: A Qualitative Inquiry. AIDS Research and Human Retroviruses, 38(1), 50-63. PMCID: PMC8785755

Abstract

BACKGROUND: Despite disproportionate incidence and prevalence of HIV among transgender individuals, cisgender women, and racial and ethnic minority groups, all remain under-represented in HIV cure research. As HIV cure trials are scaled up, there is emerging research on ways to mitigate risks of HIV acquisition for sexual partners of analytical treatment interruption (ATI) trial participants. As such, it is imperative that HIV cure researchers consider the implications of implementing ATIs in populations that are disproportionately affected by HIV but largely under-represented in trials to date.
METHODS: In this qualitative study, we sought to derive triangulated perspectives on the social and ethical implications regarding ATIs and partner protection strategies during ATIs among under-represented populations. We conducted 21 in-depth interviews with five types of informants: bioethicists, community members (people living with HIV (PLWH) and their advocates), biomedical HIV cure researchers, socio-behavioral scientists, and HIV care providers. We analyzed the data using conventional content analysis and reduced the data to important considerations for implementing ATI trials in diverse communities and settings.
RESULTS: Our study revealed the following key themes: 1) attention must be paid to gender and power dynamics in ATI trials; 2) ATI trials should be designed and implemented through the lenses of intersectionality and equity frameworks; 3) ATI trials may have both positive and negative effects on stigma for PLWH and their partners; and 4) partnership dynamics should be considered when designing ATI protocols.
CONCLUSION: Our study generated actionable considerations that could be implemented in ATI trials to promote their acceptability to communities that have been under-represented in HIV cure research to date. Research teams must invest in robust community and stakeholder engagement to define best practices. Paying attention to representation and equity will also promote better and more equitable implementation of HIV cure strategies once these become ready for roll-out.

URL

http://dx.doi.org/10.1089/aid.2021.0023

Reference Type

Journal Article

Year Published

2022

Journal Title

AIDS Research and Human Retroviruses

Author(s)

Dube, Karine
Kanazawa, John T.
Campbell, Chadwick
Boone, Cheriko A.
Maragh-Bass, Allysha C.
Campbell, Danielle M.
Agosto-Rosario, Moises
Stockman, Jamila K.
Diallo, Dazon Dixon
Poteat, Tonia
Johnson, Mallory
Saberi, Parya
Sauceda, John A.

Article Type

Regular

PMCID

PMC8785755

Continent/Country

United States of America

State

Nonspecific

Race/Ethnicity

Racial and Ethinic Minorities

Sex/Gender

Women
Transgender Women
Transgender Men

ORCiD

Poteat - 0000-0001-6541-3787