As mentioned elsewhere in this thread, https://en.wikipedia.org/wiki/Tuskegee_syphilis_experiment is one of the most important parts of the history of IRBs.
1. People who should have been treated weren't.
2. As a result of #1, more people would have been subsequently infected.
Additionally:
3. Distrust in healthcare is engendered amongst a marginalized population, with potential to lead to further incidences of undiagnosed ailments.
The net result is similar, more people are infected than would otherwise have been. Just because the infection mechanism is less obvious doesn't necessarily make it less bad.