1
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Browne JL, Rees CO, van Delden JJM, Agyepong I, Grobbee DE, Edwin A, Klipstein-Grobusch K, van der Graaf R. The willingness to participate in biomedical research involving human beings in low- and middle-income countries: a systematic review. Trop Med Int Health 2019; 24:264-279. [PMID: 30565381 PMCID: PMC6850431 DOI: 10.1111/tmi.13195] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Joyce L Browne
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Connie O Rees
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johannes J M van Delden
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Irene Agyepong
- Ghana Health Service, Research and Development Division, Accra, Ghana.,Public Health Faculty, Ghana College of Physicians and Surgeons, Accra, Ghana
| | - Diederick E Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ama Edwin
- Department of Psychological Medicine and Mental Health, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rieke van der Graaf
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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2
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Williamson V, Coetzee B, Kagee A, Tomlinson M. Factors influencing mothers' decision to enroll their HIV-negative children in a hypothetical HIV vaccine trial. Future Virol 2017; 12:19-28. [PMID: 28757895 DOI: 10.2217/fvl-2016-0090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 10/31/2016] [Indexed: 01/15/2023]
Abstract
Despite advances in preventive treatments for HIV, children continue to become infected with HIV. Research has investigated adult and adolescents' willingness to participate in hypothetical HIV vaccine trials; however, maternal willingness to enroll their infants in such trials remains underexplored. AIM This study explored the factors influencing mothers' decision-making about enrolling their HIV negative infants in a hypothetical HIV vaccine trial. Methods: HIV infected and uninfected mothers (n = 22) were interviewed. RESULTS Several factors were identified as influencing the mothers' decisions, including perceptions and knowledge of HIV and vaccines. CONCLUSION Maternal concerns about protecting their infants from HIV were also identified and mothers indicated that they were eager to vaccinate their children. Insufficient information and reassurance regarding vaccine trial safety and efficacy influenced maternal reluctance to enroll their child.
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Affiliation(s)
- Victoria Williamson
- Department of Psychology, University of Bath - Claverton Down, Bath, Bath BA2 7AY, UK.,Department of Psychology, University of Bath - Claverton Down, Bath, Bath BA2 7AY, UK
| | - Bronwyne Coetzee
- Department of Psychology, Stellenbosch University - RW Wilcocks Building, Ryneveld Street, Stellenbosch 7600, South Africa.,Department of Psychology, Stellenbosch University - RW Wilcocks Building, Ryneveld Street, Stellenbosch 7600, South Africa
| | - Ashraf Kagee
- Department of Psychology, Stellenbosch University - RW Wilcocks Building, Ryneveld Street, Stellenbosch 7600, South Africa.,Department of Psychology, Stellenbosch University - RW Wilcocks Building, Ryneveld Street, Stellenbosch 7600, South Africa
| | - Mark Tomlinson
- Department of Psychology, Stellenbosch University - RW Wilcocks Building, Ryneveld Street, Stellenbosch 7600, South Africa.,Department of Psychology, Stellenbosch University - RW Wilcocks Building, Ryneveld Street, Stellenbosch 7600, South Africa
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3
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Pillay D, Wassenaar DR. Racial differences in willingness to participate in HIV prevention clinical trials among university students in KwaZulu-Natal, South Africa. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2017. [DOI: 10.1177/0081246317708094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Students, especially women, are in the highest HIV incidence group in Sub-Saharan Africa. Willingness to participate is a crucial element in recruitment of participants for clinical trials, including HIV prevention trials. There is increasing incidence of HIV among university students, highlighting the importance of evaluating their willingness to participate in prevention trials. Assessment of willingness to participate assists in determining community preparedness for trials. This cross-sectional study aimed to evaluate willingness to participate and explore racial differences and factors associated with willingness to participate in HIV prevention research. The Clinical Research Involvement Scale and demographic questionnaire were administered online to university students aged 18–45 years at the University of KwaZulu-Natal in South Africa. The instruments evaluated associations between willingness to participate and age, gender, relationship status, parity, religion, education, student and employment status, and access to private health care. This study enrolled 636 participants, of which 509 records were analysable. Most students were willing to participate in HIV prevention research irrespective of race. However, Black students expressed greater intention to participate compared to White and Indian students. Racial differences in factors that affect intentions to participate were differences in risk perception and seeking access to better quality health care. The Clinical Research Involvement Scale is a reliable instrument in this population. Validity improved with removal of factors, motivation to comply, and outcome evaluations. These findings may not be generalizable to other student populations in Southern Africa.
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Affiliation(s)
- Diantha Pillay
- School of Family and Public Health Medicine, University of KwaZulu-Natal, South Africa
- Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Douglas R Wassenaar
- South African Research Ethics Training Initiative (SARETI), School of Applied Human Sciences, University of KwaZulu-Natal, South Africa
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4
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Harapan H, Anwar S, Bustaman A, Radiansyah A, Angraini P, Fasli R, Salwiyadi S, Bastian RA, Oktiviyari A, Akmal I, Iqbalamin M, Adil J, Henrizal F, Darmayanti D, Pratama R, Fajar JK, Setiawan AM, Imrie A, Kuch U, Groneberg DA, Sasmono RT, Dhimal M, Müller R. Community Willingness to Participate in a Dengue Study in Aceh Province, Indonesia. PLoS One 2016; 11:e0159139. [PMID: 27404663 PMCID: PMC4942142 DOI: 10.1371/journal.pone.0159139] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 06/28/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Dengue virus infection is the most rapidly spreading vector-borne disease in the world. Essential research on dengue virus transmission and its prevention requires community participation. Therefore, it is crucial to understand the factors that are associated with the willingness of communities in high prevalence areas to participate in dengue research. The aim of this study was to explore factors associated with the willingness of healthy community members in Aceh province, Indonesia, to participate in dengue research that would require phlebotomy. METHODOLOGY/PRINCIPAL FINDINGS A community-based cross-sectional study was carried out in nine regencies and municipalities of Aceh from November 2014 to March 2015. Interviews using a set of validated questionnaires were conducted to collect data on demography, history of dengue infection, socioeconomic status, and knowledge, attitude and practice regarding dengue fever. Two-step logistic regression and Spearman's rank correlation (rs) analysis were used to assess the influence of independent variables on dependent variables. Among 535 participants, less than 20% had a good willingness to participate in the dengue study. The factors associated with good willingness to participate were being female, working as a civil servant, private employee or entrepreneur, having a high socioeconomic status and good knowledge, attitude and practice regarding dengue. Good knowledge and attitude regarding dengue were positive independent predictors of willingness to participate (OR: 2.30 [95% CI: 1.36-3.90] and 3.73 [95% CI: 2.24-6.21], respectively). CONCLUSION/SIGNIFICANCE The willingness to participate in dengue research is very low among community members in Aceh, and the two most important associated factors are knowledge and attitude regarding dengue. To increase participation rate, efforts to improve the knowledge and attitude of community members regarding dengue fever and dengue-related research is required before such studies are launched.
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Affiliation(s)
- Harapan Harapan
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
- Tropical Disease Centre, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
- Department of Microbiology, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
- School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, Western Australia, Australia
| | - Samsul Anwar
- Department of Statistics, Faculty of Mathematics and Natural Sciences, Syiah Kuala University, Banda Aceh, Indonesia
| | - Aslam Bustaman
- Department of Biology, Faculty of Teacher Training and Education, Syiah Kuala University, Banda Aceh, Indonesia
| | - Arsil Radiansyah
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Pradiba Angraini
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Riny Fasli
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Salwiyadi Salwiyadi
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Reza Akbar Bastian
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Ade Oktiviyari
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Imaduddin Akmal
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Muhammad Iqbalamin
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Jamalul Adil
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Fenni Henrizal
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Darmayanti Darmayanti
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Rovy Pratama
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Jonny Karunia Fajar
- Medical Research Unit, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
| | - Abdul Malik Setiawan
- Department of Microbiology, Faculty of Medicine and Health Sciences, State Islamic University Maulana Malik Ibrahim, Malang, Indonesia
| | - Allison Imrie
- School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, Western Australia, Australia
| | - Ulrich Kuch
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | - David Alexander Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | | | - Meghnath Dhimal
- Nepal Health Research Council (NHRC), Ministry of Health Complex, Kathmandu, Nepal
| | - Ruth Müller
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
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5
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Kpanake L, Gbandey S, Sorum PC, Mullet E. Acceptability of vaccination against HIV: A mapping of Togolese people's positions. J Health Psychol 2016; 23:800-806. [PMID: 27611628 DOI: 10.1177/1359105316639440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In anticipation of a future HIV vaccine, we mapped the different personal positions regarding HIV vaccination of people in Togo. In early 2014, 363 adults indicated their willingness to receive a future HIV vaccine under different conditions varying as a function of five factors: perceived susceptibility to HIV, vaccine effectiveness, perceived severity of AIDS, vaccine cost, and family's influence. We found five qualitatively different positions: unconditional acceptance (49%), depends on cost/effectiveness ratio (20%), depends on cost (18%), total indecision (10%), and complete reluctance (3%). Accordingly, HIV vaccination strategies in Togo and elsewhere in Africa need to be multifaceted and tailored.
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6
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Dhalla S. An update on human immunodeficiency virus vaccine preparedness studies. J Med Microbiol 2015; 64:731-738. [PMID: 25908608 DOI: 10.1099/jmm.0.000073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Human immunodeficiency virus (HIV) vaccine preparedness studies (VPSs) have taken place in both the Organisation for Economic Co-operation and Development (OECD) countries and the non-OECD countries. HIV VPSs are conducted to assess the feasibility of phase 3 HIV vaccine trials. This descriptive review is an update of HIV VPSs in the non-OECD countries, and examines the willingness to participate (WTP) in hypothetical HIV vaccine trials, as well as retention. Few VPSs have been published in the OECD countries since the discontinuation of the STEP/Phambili HIV vaccine trials. Barriers to participation in the non-OECD countries after the STEP/Phambili studies include safety issues and side effects, vaccine-induced seropositivity (VISP) and mistrust among key informants (KIs). HIV VPSs indicate that HIV vaccine trials are still feasible in the non-OECD countries, but barriers must be overcome to improve feasibility. Hypothetical WTP in a VPS may not translate into actual WTP in an HIV vaccine trial.
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Affiliation(s)
- Shayesta Dhalla
- University of British Columbia, Vancouver, British Columbia, Canada
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7
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Lazarus EM, Otwombe K, Adonis T, Sebastian E, Gray G, Grunenberg N, Roux S, Churchyard G, Innes C, Laher F. Uptake of genital mucosal sampling in HVTN 097, a phase 1b HIV vaccine trial in South Africa. PLoS One 2014; 9:e112303. [PMID: 25401780 PMCID: PMC4234370 DOI: 10.1371/journal.pone.0112303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/09/2014] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED Because sexual transmission of HIV occurs across mucosal membranes, understanding the immune responses of the genital mucosa to vaccines may contribute knowledge to finding an effective candidate HIV vaccine. We describe the uptake of rectal secretion, cervical secretion and seminal mucosal secretion sampling amongst volunteers in a Phase 1b HIV vaccine trial. Age at screening, gender, study site and the designation of the person conducting the informed consent procedure were collected for volunteers who screened for the HVTN 097 study. A total of 211 volunteers (54% female) were screened at three sites in South Africa: Soweto (n = 70, 33%), Cape Town (n = 68, 32%) and Klerksdorp (n = 73, 35%). Overall uptake of optional mucosal sampling amongst trial volunteers was 71% (n = 149). Compared to Cape Town, volunteers from Soweto and Klerksdorp were less likely to consent to sampling (Soweto OR 0.08 CI: 0.03-0.25 p<0.001 and Klerksdorp OR 0.13 CI: 0.04-0.41 p = 0.001). In contrast, volunteers over 25 years of age were 2.39 times more likely to consent than younger volunteers (CI: 1.13-5.08, p = 0.02). Further studies are required to better understand the cultural, demographic and sociobehavioral factors which influence willingness to participate in mucosal sampling in HIV prevention studies. TRIAL REGISTRATION ClinicalTrials.gov: NCT02109354.
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Affiliation(s)
- Erica Maxine Lazarus
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kennedy Otwombe
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Elaine Sebastian
- Desmond Tutu HIV Foundation, University of Cape Town, Cape Town, South Africa
| | - Glenda Gray
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole Grunenberg
- Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Surita Roux
- Desmond Tutu HIV Foundation, University of Cape Town, Cape Town, South Africa
| | | | - Craig Innes
- The Aurum Institute, Klerksdorp, South Africa
| | - Fatima Laher
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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8
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Dhalla S, Poole G, Singer J, Patrick DM, Kerr T. Cognitive factors and willingness to participate in an HIV vaccine trial among HIV-positive injection drug users. PSYCHOL HEALTH MED 2012; 17:223-34. [PMID: 22250925 DOI: 10.1080/13548506.2011.608803] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
There are gaps in our knowledge of the role cognitive factors play in determining people's willingness to participate (WTP) in therapeutic HIV vaccine trials. Using a cross-sectional study of HIV-positive injection drug users (IDU), we determined the role of three cognitive factors: HIV treatment optimism, self-efficacy beliefs, and knowledge of vaccine trial concepts in relation to WTP in a hypothetical phase 3 therapeutic HIV vaccine trial. WTP was 54%. Participants tended to be low in HIV treatment optimism (mean = 3.9/10), high in self-efficacy (mean = 79.8/100), and low in knowledge (mean = 4.1/10). Items pertaining to HIV treatment optimism and knowledge of HIV vaccine trial concepts were generally unrelated to WTP. An increase in self-efficacy had a statistically significant positive association with WTP (OR = 1.61, 95% CI = 1.04-2.46, p < 0.05). Furthermore, most of these HIV-positive participants had high levels of self-efficacy, so we are most confident about this relationship at such levels. These findings indicate that interventions focused on increasing self-efficacy could enhance WTP among HIV-positive IDU.
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Affiliation(s)
- Shayesta Dhalla
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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9
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Willingness to participate in biomedical HIV prevention studies after the HVTN 503/Phambili trial: a survey conducted among adolescents in Soweto, South Africa. J Acquir Immune Defic Syndr 2011; 58:211-8. [PMID: 21765362 DOI: 10.1097/qai.0b013e31822b7702] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Adolescents may be appropriate for inclusion in biomedical HIV prevention trials. Adolescents' overall willingness to participate (WTP) in biomedical HIV prevention trials was examined, including after the prematurely discontinued phase IIb HVTN 503/Phambili HIV vaccine trial, in Soweto, South Africa. METHODS An interview-administered cross-sectional survey was conducted among 506 adolescents (16-18 years) between October 2008 and March 2009. The assessment included WTP in HIV prevention trials, sexual and substance use behavior, and related psychosocial constructs. Multivariate logistic regression analyses examined predictors of WTP in biomedical prevention trials. RESULTS The sample primarily consisted of female participants (n = 298, 59%), and 50% of all participants were sexually active. WTP in general was high (93%), with 75% WTP in a vaccine trial after being informed about the HVTN 503/Phambili trial. Less exposure to stressors [odds ratio (OR): 2.8, confidence interval (CI): 1.3 to 6.3] was associated with adolescents' WTP in HIV biomedical prevention trials overall. Those with less exposure to stressors (OR: 1.7, CI: 1.1 to 2.8) and not sexually active (OR: 2.1, CI: 1.4 to 3.3) were predictive of WTP after the HVTN 503/Phambili trial. A higher number of sexual partners were associated with unwillingness to participate more generally (P = 0.039) and specifically after the HIV vaccine trial (P = 0.0004). CONCLUSIONS The high level of adolescents' WTP in biomedical prevention trials is encouraging, especially after the prematurely discontinued HVTN 503/Phambili HIV vaccine trial. High-risk youth were less likely to be WTP, although those not yet sexually active were more WTP. Future biomedical HIV prevention trials should address challenges to enrollment of high-risk adolescents who may show less WTP.
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10
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Aliyu G, Mohammad M, Saidu A, Mondal P, Charurat M, Abimiku A, Nasidi A, Blattner W. HIV infection awareness and willingness to participate in future HIV vaccine trials across different risk groups in Abuja, Nigeria. AIDS Care 2011; 22:1277-84. [PMID: 20661789 DOI: 10.1080/09540121003692219] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The purpose of this survey is to generate baseline data on the level of HIV infection awareness and willingness to participate (WTP) in hypothetical vaccine trials, ahead of any trial conduct in Nigeria. In a cross-sectional survey, 500 respondents were interviewed, including sex workers, male motorcycle taxi drivers, students, and the general public. About 153 (30.6%) of the respondents did not believe that correct and consistent use of condom can protect people from getting HIV, while about 66 (13.2%) respondents believed it is possible to get HIV by sharing meal with an infected person. Population groups considered at high risk for HIV were less aware of the disease, however, they were more willing to participate in HIV vaccine trials compared those at low risk of the disease. A total of 55% expressed WTP in a hypothetical vaccine trial after they were informed about it. Age, population group, and ethnicity were significantly associated with WTP.
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Affiliation(s)
- Gambo Aliyu
- Department of Internal Medicine, Asokoro Hospital, Abuja, Nigeria.
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11
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Dhalla S, Nelson K, Singer J, Poole G. HIV vaccine preparedness studies in the non-organization for economic co-operation and development (non-OECD) countries. AIDS Care 2009; 21:335-48. [DOI: 10.1080/09540120802183545] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- S. Dhalla
- a University of British Columbia , School of Population and Public Health , Vancouver , BC , Canada
| | - K. Nelson
- b Departments of Epidemiology and International Health , Johns Hopkins University , Baltimore , MD , USA
| | - J. Singer
- a University of British Columbia , School of Population and Public Health , Vancouver , BC , Canada
- c St. Paul's Hospital, Vancouver , Canadian HIV Trials Network , BC , Canada
| | - G. Poole
- a University of British Columbia , School of Population and Public Health , Vancouver , BC , Canada
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12
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Sayles JN, Macphail CL, Newman PA, Cunningham WE. Future HIV vaccine acceptability among young adults in South Africa. HEALTH EDUCATION & BEHAVIOR 2009; 37:193-210. [PMID: 19509123 DOI: 10.1177/1090198109335654] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Developing and disseminating a preventive HIV vaccine is a primary scientific and public health objective. However, little is known about HIV vaccine acceptability in the high-prevalence setting of South Africa- where young adults are likely to be targeted in early dissemination efforts. This study reports on six focus groups ( n = 42) conducted in 2007 with South Africans aged 18 to 24 years. A deductive framework approach is used to identify key motivators and barriers to future HIV vaccine uptake. Participants identify HIV testing, HIV stigma, mistrust of the health care system, and concerns about sexual disinhibition as barriers to vaccine uptake. For women, family members and friends are strong motivators for vaccine uptake, whereas men are more likely to see vaccines as an opportunity to stop using HIV prevention strategies such as condoms and partner reduction. Implications of these findings for developing HIV vaccine dissemination strategies and policy in South Africa are discussed.
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Affiliation(s)
- Jennifer N Sayles
- UCLA Division of General Internal Medicine, 911Broxton Plaza, Los Angeles, CA 90024, USA.
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13
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Lau CY, Stansbury JP, Gust DA, Kafaar Z. Social and behavioral science in HIV vaccine trials: a gap assessment of the literature. Expert Rev Vaccines 2009; 8:179-90. [PMID: 19196198 DOI: 10.1586/14760584.8.2.179] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Social and behavioral science research is integral to the conduct of HIV vaccine trials, especially because the vaccine targets an infection laden with sensitive human issues. Although social and behavioral sciences have played a larger role in HIV vaccine clinical trials than other vaccine clinical trials to date, this role should be expanded. Fortunately, related publications, conference coverage and research proposals are on the rise; community engagement is receiving more attention during the earlier stages of product development; and collaboration between HIV vaccine scientists and social and behavioral scientists is being fostered. Greater attention to social and behavioral science issues could not only facilitate accrual, but also improve research efficiency and relevance. In this review, gaps in the literature on social and behavioral science issues in HIV vaccine clinical research, including barriers and facilitators to trial participation, enhancing feasibility of trial success, health systems, policy and monitoring social and behavioral issues, are identified and directions are suggested for filling those gaps. Development of a safe, efficacious and acceptable HIV vaccine will be nurtured by addressing the gaps through interdisciplinary collaborations.
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Affiliation(s)
- Chuen-Yen Lau
- Vaccine Clinical Research Branch, Vaccine Research Program, National Institute of Allergy and Infectious Disease, National Institutes of Health, 6700 B Rockledge, Room 5126, Bethesda, MD 20817, USA.
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14
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Giocos G, Kagee A, Swartz L. Predicting hypothetical willingness to participate (WTP) in a future phase III HIV vaccine trial among high-risk adolescents. AIDS Behav 2008; 12:842-51. [PMID: 17668313 DOI: 10.1007/s10461-007-9289-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2007] [Accepted: 07/16/2007] [Indexed: 11/28/2022]
Abstract
The present study sought to determine whether the Theory of Planned Behaviour predicted stated hypothetical willingness to participate (WTP) in future Phase III HIV vaccine trials among South African adolescents. Hierarchical logistic regression analyses showed that The Theory of Planned Behaviour (TPB) significantly predicted WTP. Of all the predictors, Subjective norms significantly predicted WTP (OR = 1.19, 95% C.I. = 1.06-1.34). A stepwise logistic regression analysis revealed that Subjective Norms (OR = 1.19, 95% C.I. = 1.07-1.34) and Attitude towards participation in an HIV vaccine trial (OR = 1.32, 95% C.I. = 1.00-1.74) were significant predictors of WTP. The addition of Knowledge of HIV vaccines and HIV vaccine trials, Perceived self-risk of HIV infection, Health-promoting behaviours and Attitudes towards HIV/AIDS yielded non-significant results. These findings provide support for the Theory of Reasoned Action (TRA) and suggest that psychosocial factors may play an important role in WTP in Phase III HIV vaccine trials among adolescents.
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Affiliation(s)
- Georgina Giocos
- Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, Stellenbosch, 7602, South Africa
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15
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Stadler JJ, Delany S, Mntambo M. Women's perceptions and experiences of HIV prevention trials in Soweto, South Africa. Soc Sci Med 2007; 66:189-200. [PMID: 17904718 DOI: 10.1016/j.socscimed.2007.08.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Indexed: 10/22/2022]
Abstract
Persistently high rates of HIV infection in sub-Saharan Africa have driven the exploration for additional methods of prevention, such as microbicides. Multi-site, field-based clinical trials of microbicides are conducted in diverse social and cultural contexts. Local social and cultural perceptions of HIV/AIDS and sexual risk can have profound implications in shaping community responses to the clinical trials, thereby affecting enrollment and retention. Moreover, clinical trials may have a significant impact on trial participants with regard to their views of AIDS, health and relationships. Following these issues, this paper explores the subjective experiences of women enrolled in a microbicide feasibility study. Qualitative data were collected in two phases. The first phase took place prior to the inception of the feasibility study. Men and women from Soweto participated in focus group discussions about their perceptions and experiences of the AIDS epidemic and sexual risk. The second phase started once enrollment into the feasibility study had begun. Twenty-one women who were enrolled in the microbicide feasibility study were interviewed and participated in focus groups, and were asked about their experiences of participating in the microbicide feasibility study. Special attention was placed on how they felt their participation had affected their everyday lives. Interviews and discussions were conducted in local languages, recorded, translated and transcribed. Data were analysed thematically. The central finding of this study is the sense of empowerment that feasibility study participants felt in spite of their being embedded in a culture that has come to fear, deny or ignore AIDS. We discuss the critical role of repeated, voluntary counselling and testing, knowledge of HIV status, and heightened awareness of sexual and reproductive health in reshaping study participants' approaches to sexual relationships and AIDS, as well as the benefits that participation entailed.
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Affiliation(s)
- Jonathan J Stadler
- Reproductive Health and HIV Research Unit, Hillbrow Health Precinct, Hugh Solomon Building, Esselen Street, Johannesburg 2001, South Africa.
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Barrington C, Moreno L, Kerrigan D. Local understanding of an HIV vaccine and its relationship with HIV-related stigma in the Dominican Republic. AIDS Care 2007; 19:871-7. [PMID: 17712690 DOI: 10.1080/09540120701203295] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The purpose of this study was to explore local perceptions and experiences regarding vaccines in general and HIV vaccines and vaccine trials in the Dominican Republic. In-depth interviews were carried out with 25 participants representing two study groups: (1) individuals considered at high risk for HIV infection including female sex workers and male STI clinic attendees and (2) individuals considered at low risk of HIV infection including women and men recruited at a general outpatient clinic. Across the groups, participants often characterized vaccines in general as having both preventive and curative properties. In turn, one of the most salient concerns regarding the receipt of an HIV vaccine was the fear that one would be labelled 'HIV positive' and stigmatized, as the vaccine may be perceived as a cure for those already infected. These findings suggest the importance of individual and community level education to clarify the nature and mechanisms of the given HIV vaccine being tested. Social support and counselling services should also accompany HIV vaccine trials and distribution plans to assist individuals in determining if and how they communicate their participation and/or receipt of an HIV vaccine to others and manage potential negative social reactions.
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Affiliation(s)
- C Barrington
- International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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