application's abstract): The HIV/AIDS epidemic currently affects African Americans, Latinos, women and injection drug users, populations that have traditionally been underrepresented in HIV clinical trials. Alarmingly, while the rate of HIV/AIDS is 10.4 per 100,000 among whites, it is 83.7 and 37.7 per 100,000 among African Americans and Latinos, respectively. The Harlem AIDS Treatment Group (HATG) was established in 1989 with the primary goal of providing access to HIV trials for persons of color, women, and injection drug users. It was recognized, however, that accomplishing this goal would be challenging due to the legacy of mistrust of research and the many social needs of the population. In spite of these challenges, through concerted educational efforts, the building of community support, the recruitment of a talented and committed staff and the provision of the research in the context of state-of-the-art care, HATG has been able to achieve its goals. A total of 957 participants have been enrolled in 27 CPCRA studies with 1,436 separate enrollments including 65.3 percent African American, 15.7 percent Latino, 31.7 percent women and 41.1 percent with a history of injection drug use. Through the, outreach and tracking systems, the provision of support services and the devotion of the participants to their care, HATG has had a 97 percent retention rate. The accomplishments of HATG are firmly embedded in the success of its Community Advisory Board, which has been a vibrant venue for community input and whose functions are solidly linked to unit activities. HATG investigators have made significant contributions to the CPCRA science by providing leadership in the study of tuberculosis, P. carinii pneumonia, funga1 infections, and nutrition/metabolic complications. Their efforts have culminated in multiple publications and presentations. HATG expects to follow at a minimum 270 participants in trials at Harlem Hospital Center, the Renaissance Health Care Network, Jacobi Medical Center and the St. Vincent's Comprehensive HIV Center. Overall, HATG sites provide care to more than 4,000 persons living with HIV, predominantly African Americans, Latinos, women and injection drug users. This population spans the spectrum of HIV disease and includes a substantial group with recently recognized HIV infection who are antiretroviral naive. All HATG site investigators have the expertise, experience and commitment to make substantial contributions to the CPCRA science in adherence, metabolic/nutrition, opportunistic infection prophylaxis and hepatitides. They also are committed to the conduct of large long-term studies as a means of answering key questions in HIV management that cannot be answered through shorter trials.
