(Reuters Health) - Although women represent about half of HIV cases worldwide, they remain largely excluded from clinical trials testing drugs, vaccines and potential cures for the virus or AIDS, confirms a search.
In an analysis spanning several decades which included work in 2012, the researchers found that women make up typically about 11 percent of trial participants seeking solutions to the epidemics of HIV / AIDS. Likewise, drug studies were only about 19 percent of women and only 38 percent of individuals of the vaccine trial were female.
"Based on previous studies in other health areas, it was not surprising, but perhaps disappointing, given that almost half of people living with HIV are women," said study author Dr. Mirjam Curno, who did the analysis while working as editor in chief of the Journal of the International AIDS Society, said by email.
Research in areas such as heart disease, cancer and depression also have a historically low female participation, as well as advanced human trials testing experimental drugs, observe Curno and colleagues in the Journal of Acquired Immune Deficiency Syndromes.
While it may make sense to have fewer women in studies focused on diseases that disproportionately affect men, the search results may ignore specific genres, damages or benefits when the proportion of men and women in the study is very different from what happens in the real world, said the study's senior author Dr. Shirin Heidari by email.
This is because even when the disease is the same, women may have different symptoms from men, and respond in unique ways to the treatments being tested.
"Failing to systematically study the differences of sex and gender in health research leads to less evidence-based medicine for one sex or the other," Heidari said, who is president of gender policy committee for the European Association of Science Editors.
The analysis of gender disparities in HIV testing inclíram over 500 studies published in prominent medical journals over several decades.
A limitation of the analysis is that by relying on published work, it can not capture any differences in gender composition of more recent trials have not yet been completed, the authors acknowledge.
It is possible that at least some studies in the analysis have not been made to favor men, but eventually enroll fewer female participants due to obstacles that may disproportionately affect women, such as lack of child care or elderly or limited transport or the time to participate, observed Mary Foulkes a biostatistics researcher at George Washington University in Washington, DC
An unanswered question is the analysis because the eligible women may have decided not to participate, Foulkes, who was not involved in the study, said by email.
Sometimes the criteria for inclusion in the test may be too restrictive to enroll enough women, for example, prohibiting pregnant women, breastfeeding or of childbearing age. In the past, the eligibility criteria excluded a large number of women, even in HIV tests designed to study female patients, noted Dr.. Monica Gandhi, an HIV expert at the University of California, San Francisco.
The underrepresentation of women in HIV testing may cause the findings have limited use in the treatment of female patients, said Gandhi, who was not involved in the study, by email.
"When I take care of a woman infected with HIV in my clinic, I do not know if this new and exciting treatment or strategy specifically applies to it if the study does not include enough people in this or that study that look like her," said Gandhi.