RECENT efforts to extend clinical acquired immunodeficiency syndrome (AIDS) research trials to urban, poor, minority communities suggest that a new paradigm is required to make such efforts succeed. This new paradigm must reflect the special needs of these communities and should recognize historical distrust of clinical trials and the need for extensive educational and social support services.
The AIDS epidemic has focused attention on research and access to experimental therapy. The intensity of public debate may be new, but the problems are not. The proper sampling of a heterogeneous population has long been an important consideration in epidemiologic and clinical research, and it is well appreciated that race can affect disease severity and progression as well as response to drug therapy. A number of studies have shown differences between African Americans and whites in response to antihypertensive therapy.1-3 These studies suggest that race is an important consideration when planning and