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Therapeutic trials in HIV infection: which benefits for which patients?
L Piroth1, J Y Callerot, M Grappin
1Service des Maladies Infectieuses et Tropicales, Hôpital d'Enfants, CHU Dijon, France.
Purpose:
The purpose of our study was to make an assessment of the HIV patients' overall opinion of therapeutic trials, to analyze the motivations and the reasons linked to this perception, and to determine if their involvement in a therapeutic trial is a help or a hindrance to their treatment.
Method:
All the inpatients and outpatients attending the Dijon University Hospital AIDS day care unit during the first 4 months of 1999 were given an anonymous questionnaire designed to record the patients' attitudes toward therapeutic trials, their motivations, and the perceived risks. The questionnaire was often completed in consultation with a psychoanalyst.
Results:
Two hundred and seven (207) patients were surveyed; 194 of them had a favorable opinion of therapeutic trials. The main motivations to take part in a therapeutic trial were altruistic. In contrast, individualistic considerations and relational motivations (such as to modify the relationship between the caregiver and the patient) were more closely associated with a negative perception.
Conclusion:
Most of the patients will benefit or at least will not be harmed by being involved in a trial. However, the patients' attitudes toward the principle of therapeutic trials have to be determined before these patients are included in a given therapeutic trial. This is necessary to avoid the risk of subsequent medical care being altered because participation was either induced or compelled.