Responses to NIH-Specific Recommendations (Extracted from: America Living with AIDS)

CARING FOR PEOPLE WITH HIV DISEASE

#2 HIV-related services should be expanded to facilities where
underserved populations receive health care and human
services, in part to ensure their increased participation in
trials of investigational new therapies.
In our experience, a major reason that populations such as
minorities, women, and IV drug users are underrepresented in
clinical trials of potential therapeutics is that these
populations are also underserved with respect to primary
health care and human services. We therefore believe that
the expansion of HIV-related services to such facilities
would help to increase access of these populations to
experimental therapies. While it is not within the mission
of the NIH to provide health care and human services, the
NIH has begun collaborative efforts with HRSA and with
ADAMHA to link NIH efforts with programs of the other
agencies that involve provision such services of in order to
improve access of underserved populations to trials. A
collaborative effort with NIDA has resulted in a significant
rate of increase in the accrual of IVDUs into clinical
trials. In addition to continuing to monitor the
performance of co-funded sites in terms of accrual of IVDUs,
the NIH plans to continue staff collaboration activity in
order to further address issues related to accrual and
retention of IVDUs, as well as protocols designed
specifically for IVDUs.
#3 HIV education and training programs for health care
providers should be improved and expanded, and better
methods should be developed to disseminate state-of-the-art
clinical information about HIV disease, as well as drug and
alcohol use, to the full range of health care providers.
The NIH agrees that education and training of health care
providers concerning clinical management of HIV-infected
persons is of utmost importance and that state-of-the-art
clinical information needs to be made available to
providers. This is particularly important for providers
outside the academic arena in private or community-based
practices where such information has traditionally been
unavailable such as rural areas of the U.S. The NIH
participates with the other PHS agencies in the development
of clinical guidelines. The NIH has been collaborating with
HRSA to sponsor meetings designed to transmit state-of-theart information to providers through the HRSA-sponsored
Educational Training Centers. Two meetings have been held
in Puerto Rico. The NIH plans continue this collaborative
effort as more information becomes available concerning
clinical management of HIV infection.