"Research participants want to feel they are better off than they were before research was introduced to them": engaging cameroonian rural plantation populations in HIV research

COVID-19 Vaccine Hesitancy in Cameroon: The Role of Medical Mistrust and Social Media Use

Most African countries report low COVID-19 vaccination rates (Msellati et al., 2022; WHO Africa; 2020). This study focuses on factors associated with vaccine hesitancy specifically in the country of Cameroon. Social media use and medical mistrust have been suggested as key variables that may increase vaccine hesitancy. Adopting the information-related perspective guided by the risk information seeking and processing model, the current research explored how social media use and medical mistrust are related to vaccine hesitancy among Cameroonians. Survey results from a sample of 1,000 Cameroonians fielded in early 2022 showed that social media use and medical mistrust were positively associated with belief in misinformation related to the COVID-19 vaccine. Belief in misinformation about the COVID-19 vaccine was negatively associated with perceived information insufficiency. A positive relationship between perceived information insufficiency and information seeking, as well as a negative relationship between information seeking and vaccine hesitancy were also found. Theoretical and practical implications are discussed.

The willingness to participate in biomedical research involving human beings in low- and middle-income countries: a systematic review

Objectives

To systematically review reasons for the willingness to participate in biomedical human subjects research in low‐ and middle‐income countries (LMICs).

Methods

Five databases were systematically searched for articles published between 2000 and 2017 containing the domain of ‘human subjects research’ in ‘LMICs’ and determinant ‘reasons for (non)participation’. Reasons mentioned were extracted, ranked and results narratively described.

Results

Ninety‐four articles were included, 44 qualitative and 50 mixed‐methods studies. Altruism, personal health benefits, access to health care, monetary benefit, knowledge, social support and trust were the most important reasons for participation. Primary reasons for non‐participation were safety concerns, inconvenience, stigmatisation, lack of social support, confidentiality concerns, physical pain, efficacy concerns and distrust. Stigmatisation was a major concern in relation to HIV research. Reasons were similar across different regions, gender, non‐patient or patient participants and real or hypothetical study designs.

Conclusions

Addressing factors that affect (non‐)participation in the planning process and during the conduct of research may enhance voluntary consent to participation and reduce barriers for potential participants.

Improving ethical and participatory practice for marginalized populations in biomedical HIV prevention trials: lessons from Thailand

Background

This paper presents findings from a qualitative investigation of ethical and participatory issues related to the conduct of biomedical HIV prevention trials among marginalized populations in Thailand. This research was deemed important to conduct, as several large-scale biomedical HIV prevention trials among marginalized populations had closed prematurely in other countries, and a better understanding of how to prevent similar trial closures from occurring in the future was desired.

Methods

In-depth key informant interviews were held in Bangkok and Chiang Mai, Thailand. Interviews were audio recorded, transcribed, translated and thematically analyzed. The Good Participatory Practice Guidelines for Biomedical HIV Prevention Trials (GPP) guided this work.

Results

Fourteen interviews were conducted: 10 with policymakers, academic and community-based researchers and trial staff and four with representatives of non-governmental organizations (NGOs). Suggested ways to improve ethical and participatory practice centered on standards of HIV prevention, informed consent, communication and human rights. In particular, the need to overcome language and literacy differences was identified. Key informants felt communication was the basis of ethical understanding and trust within biomedical HIV prevention trial contexts, and thus fundamental to trial participants' ability to exercise free will.

Discussion

Biomedical HIV prevention trials present opportunities for inclusive and productive ethical and participatory practice. Key informants suggested that efforts to improve practice could result in better relationships between research stakeholders and research investigative teams and by extension, better, more ethical participatory trials. This research took place in Thailand and its findings apply primarily to Thailand. However, given the universality of many ethical considerations, the results of this study can inform the improvement of ethical and participatory practice in other parts of the world where biomedical HIV prevention trials occur, and where clinical trials in marginalized populations continue.