Consensus Building on Strategies That Address Medical Mistrust to Better Engage Priority Populations in HIV Cure...

Poor diversity within HIV cure-related trials has been attributed to medical mistrust. Therefore, we sought to identify strategies to overcome medical mistrust to increase participation in HIV cure research in the United States. We used a hybrid Delphi consensus-building process with a panel of multidisciplinary experts in HIV cure research (n = 54). The panel completed three surveys over time. The panel was organized into six groups: community members/experts; biomedical researchers; HIV care providers; funders and private industry members; bioethicists, regulators, and institutional review board members; and socio-behavioral scientists/medical mistrust experts. Forty-eight of the 54 panelists completed all three surveys. In round one, the panel provided qualitative responses on strategies to overcome medical mistrust. These responses were organized and, in subsequent surveys, listed as unique strategies that were ranked from most to least important, arriving at consensus. Across the six groups, the top-ranked strategy was "[connecting] eligible participants with people with HIV who have participated in [HIV cure trials] and are willing to share experiences (both positive and negative)." Another top-ranked strategy was to "engage in active listening to ensure that all questions and concerns presented by… eligible participant[s] are addressed [and] build trust and rapport." Rankings varied slightly between groups. Investigative teams could prioritize peer-to-peer interactions to overcome medical mistrust and promote participation in novel HIV cure research.