Did whites say an AIDS vaccine failed because it did not work for them?
At the end of February, VaxGen, the company testing the AIDS vaccine known as AIDSVAX, released the long-awaited results from the first-ever 5,000-plus-person trial. The verdict? The vaccine was judged ineffective overall—it cut the infection rate by only 3.8 percent, a “statistically insignificant” amount. However, it seemed to decrease the infection rates in African Americans and Asian Americans: Four out of 203, or 2 percent of, blacks on the vaccine tested positive, compared to nine out of 111, or 8 percent, who got the placebo; two out of 53 Asian Americans on the vax seroconverted (4 percent) vs. two out of 20 (10 percent) in the placebo group. The question is: How significant are those differences in such a small group?
Not very, according to several important AIDS activists and researchers. In the media coverage breaking the news, they dismissed the vaccine as ineffective. But a number of activists of color complained about the willingness to trash the entire trial. Said Terrance Marks of the San Francisco–based Black Coalition on AIDS, “Every single article I read said this was a failure even though it helps a number of African Americans.”
There is historical precedent to justify distrust of medical science among people of color—and a sense that white folks dis the goods as long as they don’t work for them, not caring how well they may work for other groups. When you feel as though you’re always on the back of the bus, a promise written off so quickly taps into long-simmering fear and resentment.
Whether a vaccine might be distinctly beneficial to African-American and Asian-American people (and, by extension, the many millions of Africans and Asians at risk) is a question worthy of study. The AIDSVAX trial nearing completion in Thailand may help answer it. Researchers in breast cancer and cardiovascular health—and in other areas of HIV research—are investigating why health outcomes can be so different among subpopulations. So should those looking for an HIV vaccine.
Still, vaccine trials do not address a core issue: structural inequality. We need to focus our research and interventions not only on the virus, but on the disparities in power that fuel the pandemic.
Dredge Byung’chu Kang, Health Education director at Asian and Pacific Islander Wellness Center, is on the Community Advisory Board of the San Francisco Health Department’s HIV Research Section.