Research Initiative Treatment Action (RITA!); Vol 6, No. 2 June 2000
Houston is the fourth largest city in the United States and ranks seventh in number of AIDS cases. Still, 20 years after the start of the epidemic, the Bayou City had yet to launch a functioning, federally funded adult HIV clinical trials unit. In the mid-1980s, Houston was awarded government funds to participate in what is now the adult AIDS Clinical Trials Group (ACTG). But the ACTG never got fully off the ground here, in part because of local politics, and Houston's contribution to HIV clinical research was relegated largely to the realm of pharmaceutical company studies.
Then, at the1998 World AIDS Conference in Geneva, Roberto Arduino, MD, a young, energetic academic from Houston, delivered a lecture at a National Institutes of Health (NIH) meeting on the use of interleukin-2 for the treatment of HIV. Investigators from the Community Programs for Clinical Research on AIDS (CPCRA), a government-supported research initiative, were in the audience that day. Impressed with his work and enthusiasm, they invited Arduino to apply for a CPCRA unit of his own. He did, and in March of this year the NIH awarded it to him.
Established in 1989, CPCRA conducts clinical research in primary care settings, where most people with HIV receive care. It focuses on the inclusion of populations that have been historically underrepresented in AIDS research, namely people of color, women and injection drug users. CPCRA and ACTG are the 2 programs funded by the federal government to conduct research on the management of adult HIV disease. Larger and generally more respected than CPCRA, the ACTG will get $80 million a year for the next 5 years; CPCRA currently has a one-year commitment for $19.4 million. The money will be distributed among 14 CPCRA units nationwide, with the Houston unit getting about $700,000.
Houston's CPCRA unit—dubbed "HART," for Houston AIDS Research Team—will operate out of 3 sites: Thomas Street Clinic, Montrose Clinic and the Veterans Affairs Medical Center. Arduino, an assistant professor at the University of Texas Medical School, will serve as principal investigator. Co-investigators include Maria Rodriguez-Barradas, MD, Chris Lahart, MD, and Shannon Schrader, MD.
Since its inception, CPCRA has completed 18 studies, enrolling more than 15,000 volunteers. The program is proud of its low study dropout rate (generally less than 3%) and of its ability to recruit women and minorities. Arduino hopes to build on those assets. "This grant brings two benefits to our community: opportunity for HIV-infected people to participate in federally funded clinical trials and collaboration between the county, the federal government and the private sector," Arduino noted.
Although CPCRA units are located in primary care settings, the program does not provide primary HIV care. Instead, it focuses on answering important research questions. For example, CPCRA has conducted trials to determine whether HIV affects men and women differently and whether weight loss decreases survival. According to Paul Simmons, chair of the Community Advisory Board for HART, "For a long time, the best our people could do was participate in drug company studies to see if the green pill was better than the yellow one. But now, with a CPCRA unit, HIV-infected Houstonians can help to answer important scientific questions—questions that affect peoples' lives."
Enrollment in CPCRA studies will begin later this year. HIV-infected Houston area residents interested in participating in this federal research can call the following persons for more information:
Individuals interested in serving on the community advisory board, which offers patient input on the design and conduct of CPCRA studies, can call Paul Simmons at 713.527.8219.
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Copyright © 2000 - Research Initiative Treatment Action (RITA!). Reproduced with permission. RITA! is published by The Center for AIDS. Contact Thomas Gegeny, MS, ELS, Editor, RITA! for permission to reproduce RITA!. tom@centerforaids.org. http://www.centerforaids.org
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