Expanding Prisoners' Access to AIDS-Related Clinical Trials: An Ethical and Clinical Imperative

Abstract

In the AIDS pandemic, access to experimental treatments has become an important element of community-standard medical care. Rates of AIDS and HIV infection are significantly higher in prison and jail populations than in the U.S. population at large; however, prisoners are denied access to AIDS-related clinical trials in all but a handful of jurisdictions. The author argues for expanded prisoner access to AIDS-related clinical trials and demonstrates that such access is ethical and feasible. Enrolling prisoners in AIDS-related trials would stand to benefit not only affected prisoners but also clinical researchers seeking to gather information on the efficacy of treatments in all population groups contained within the larger HIV-infected population, including African Americans, Latinos, and IV drug users. Existing federal regulations, properly enforced, provide prisoners with adequate protection from exploitation conducted in the name of science. Barriers remain, in the form of state laws, correctional policies, and practical obstacles presented by the prison environment. However, as the author describes, research institutions in several states have succeeded in incorporating prisoners into clinical drug trials.