Minorities, Drug Users Targets of AIDS Research

Federal health officials, in an “outreach” attempt to make AIDS clinical research accessible to minorities, women and intravenous drug abusers, Thursday announced $9 million in contracts to AIDS community-based programs in 14 cities.

“We look upon this as science at the community level,” said federal AIDS chief Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.

Fauci said at a press conference that the programs are intended to produce valid scientific data from “non-traditional” sources. He said that they will draw on the expertise of health workers in local clinics and other facilities already treating AIDS patients. The hope, he said, is to include AIDS patients previously under-represented in traditional studies typically carried out at large academic medical centers.

“As (AIDS) infection has spread among blacks, Hispanics, intravenous drug users, women and children, we at the NIAID have felt a particular urgency to reach out to people in these groups and offer them the opportunity to participate in clinical research,” Fauci said.

But some groups were angry that they did not receive grants funding their proposals. The New York-based Community Research Initiative, which is considered a pioneer, was one of the groups whose proposal was not funded. CRI, along with the County Community Consortium of San Francisco, contributed data that led to the recent federal approval of aerosol pentamidine to prevent pneumocystis carinii pneumonia, a life-threatening AIDS infection. The consortium, however, did receive a grant.

Michael Callen, president of CRI, complained that his group’s exclusion was a “politically motivated slap,” by NIAID. But he said that his program “will survive without NIAID funding.”

The American Foundation for AIDS Research criticized the selections as programs that were “not truly community-based.”

“We have a different definition of community-based clinical research,” said David Corkery, a spokesman for AMFAR. “Many of the groups that were funded were either university-based, or hospitals.”

Fauci said that the programs were chosen by “peer-review” committees composed of community clinicians, nurses, social workers, researchers, people infected with human immunodeficiency virus and “representatives of the groups now under-represented in clinical trials.” The committees “scored” the proposals, and those with the highest scores were selected. The contracts are for five years, with $9 million funded for the first year.

Jean McGuire of the AIDS Action Council, who sat on one review committee, said that she was not involved in evaluating CRI’s proposal but said that the review process was “rigorous and equitable” but “there just wasn’t enough money to go around.”

Fauci admitted he was surprised that CRI was not selected, so much so that he called a special staff meeting to find out why. “I was very concerned. . . . I would have liked to see CRI get funded, I really would have. But I saw their score clearly put them out of the fundable range.” He said he could not publicly disclose the reasons for the decision.

Dr. Neil Schram, a Harbor City, Calif., physician who heads the AIDS task force for the American Assn. of Physicians for Human Rights, decried the lack of funding for other gay-identified groups in addition to CRI, such as the Whitman-Walker Clinic in Washington and the Fenway Health Center in Boston.

“The whole idea behind community-based research is to involve the doctors on the front lines,” he said. Gay doctors “are where the patients are and where the experience is,” he added.

No Los Angeles programs were funded.

Staff writer Victor F. Zonana in San Francisco contributed to this story.