The National Institutes of Health (NIH) is committed to helping eliminate health disparities that affect minority populations and the medically underserved by increasing research into these areas, by providing research opportunities to scientists from minority populations, and by enhancing outreach efforts. Research to address the disproportionate impact of the HIV/AIDS epidemic on U.S. racial and ethnic minority communities continues to be a high priority of the Office of AIDS Research (OAR). 

Funding for AIDS-related research continues to increase and in FY 2001, OAR established an Ad Hoc Working Group on Minority Research that advises OAR on the scientific priorities in this critical research area. Of broader significance is the establishment in December 2000 of a new NIH center, the National Center on Minority Health and Health Disparities (NCMHD), with initial funding of $130 million, an increase of $33 million over the comparable FY2000 level. 

Significant gains have been made in the treatment of HIV infection, as well as in the elucidation of the complex mechanism involved in the pathogenesis and pathophysiology of HIV infection. Despite these gains, for over two decades, HIV infection has continued an inexorable march across racial and ethnic minority communities in the United States. The increased number of treatment options, as well as the expanding number of clinical trials, has not significantly altered the course of HIV infection or transmission in these communities. Racial and ethnic minorities continue to dominate new AIDS cases, as well as new HIV infections. Many urban centers within the United States reflect HIV seroprevalence rates among racial and ethnic minorities that mimic those in the developing world.

The interplay of cultural, economic, political, individual, and societal factors in general, especially within racial and ethnic minority communities, requires comprehensive and innovative interventions. These interventions must include greater emphasis upon the training of minority scientists, as well as a long-term commitment to the production of skilled independent investigators. The demographics of the epidemic, in stark contrast to the demographics of both extramural and intramural NIH investigators, reveal a widening divide between those infected and those conducting research upon the infected.

However, race and ethnicity alone are insufficient to bridge the gap between the scientific community and the communities most affected by HIV infection. Within these communities, the main routes of HIV infection—unprotected sexual intercourse and substance abuse—are inextricably linked to a range of underlying community and societal factors, as well as community norms and culture. Cultural competency, or the ability to see the world through the lens of a particular culture, not just cultural awareness, is a critical skill in understanding the context of the epidemic in racial and ethnic minority communities. In addition to understanding the cultural context of HIV infection, these skills can result in designing clinical research that will produce outcomes that have relevance for these communities. Focus groups have repeatedly demonstrated that research conducted with communities, rather than "for" or "on" communities is the only research that will be acceptable.

Participation of racial and ethnic minority communities in clinical research can only serve to broaden scientific knowledge about HIV infection. This would include identifying the impact, or lack thereof, of specific racial factors upon HIV pathogenesis, transmission, susceptibility, disease progression, and disease manifestation. The high rates of other co-morbid diseases in racial and ethnic minority communities, such as hepatitis C, also provide additional opportunities to determine the effect of these disease states upon not only HIV infection, but also upon treatment options for HIV infections, or the sequelae of treatment, such as metabolic abnormalities. To achieve this objective, recruitment and retention strategies for clinical studies must be appropriate for the target population. Partnerships between NIH-funded research institutions and institutions within the community, including community-based organizations, present an opportunity for unique collaborations and greater community participation. Through these partnerships the community and NIH can benefit from an exchange of ideas from research design to dissemination of research results.

For more information on the NIH AIDS Research Program and Minority Populations, including information on Scientific Objectives and Strategies, please refer to the NIH Plan for HIV-Related Research:

• FY 2003 (PDF)
• FY 2002 (PDF)
• FY 2001 (Spanish Version PDF)
• FY 2000 (Spanish Version PDF)

Additionally, the OAR has currently allocated funds for two specific areas:

• Community Outreach Programs
• Formal Collaborative Programs

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Last Update:  17 September 2001