PEARLS Study an Impressive Accomplishment

One of the most frequent criticisms of randomized clinical trials of HIV therapy is that certain patient groups — in particular, men who have sex with men (MSM) — are overrepresented, given the demographics of the HIV-infected population as a whole. For example, in recently reported clinical trials of the Quad pill and dolutegravir, women accounted for <20% of the study populations, despite representing approximately 50% of those living with HIV worldwide.

Now along comes the PEARLS study, with one of the most diverse study populations ever seen in this field. This randomized trial — conducted in Brazil, Haiti, India, Malawi, Peru, South Africa, Thailand, the U.S., and Zimbabwe — involved 1571 HIV-infected treatment-naive patients, nearly ha…