少数民族社区参与HIV疫苗试验:障碍、动机及招募意义
HIV vaccine trial participation among ethnic minority communities: barriers, motivators, and implications for recruitment.
作者信息
Newman Peter A, Duan Naihua, Roberts Kathleen J, Seiden Danielle, Rudy Ellen T, Swendeman Dallas, Popova Svetlana
机构信息
Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
出版信息
J Acquir Immune Defic Syndr. 2006 Feb 1;41(2):210-7. doi: 10.1097/01.qai.0000179454.93443.60.
BACKGROUND
Underrepresentation of ethnic minority communities limits the generalizability of HIV vaccine trial results. We explored perceived barriers and motivators regarding HIV vaccine trial participation among low-socioeconomic ethnic minority respondents at risk for HIV.
METHODS
Six focus group interviews were conducted using a semistructured interview guide. Participants (N = 58, mean age = 36 years, 37% female, and 56% Latino/a and 35% African American) were recruited using venue-based sampling in Los Angeles. Data were analyzed using narrative thematic analysis and Ethnograph qualitative software.
RESULTS
Perceived barriers to HIV vaccine trial participation, in rank order, were (1) vaccine-induced HIV infection, (2) physical side effects, (3) uncertainty about vaccine efficacy, (4) uncertainty about other vaccine characteristics, (5) mistrust, (6) low perceived HIV risk, (7) study demands, (8) stigma, and (9) vaccine-induced HIV seropositivity. Motivators were (1) protection against HIV infection, (2) free insurance and/or medical care, (3) altruism, and (4) monetary incentives.
CONCLUSIONS
Population-specific HIV vaccine trial recruitment and implementation strategies should address trial risks from a family perspective, cultural gender norms, mistrust, low perceived HIV risk, the importance of African-American and Latino/a community participation in HIV vaccine trials, and misconceptions about gaining protection against HIV infection. Increasing the cultural relevance of trial recruitment and implementation should facilitate the participation of Latinos/as and African Americans in HIV vaccine trials.
背景
少数族裔群体代表性不足限制了HIV疫苗试验结果的普遍性。我们探讨了处于HIV感染风险中的低社会经济地位少数族裔受访者在参与HIV疫苗试验方面所感知到的障碍和动机。
方法
使用半结构化访谈指南进行了六次焦点小组访谈。参与者(N = 58,平均年龄 = 36岁,37%为女性,56%为拉丁裔/拉丁美洲人,35%为非裔美国人)通过在洛杉矶基于场所的抽样方法招募。使用叙事主题分析和Ethnograph定性软件对数据进行分析。
结果
按顺序排列,参与HIV疫苗试验所感知到的障碍为:(1)疫苗导致的HIV感染,(2)身体副作用,(3)疫苗效力的不确定性,(4)其他疫苗特性的不确定性,(5)不信任,(6)感知到的HIV风险低,(7)研究要求,(8)耻辱感,(9)疫苗导致的HIV血清阳性。动机包括:(1)预防HIV感染,(2)免费保险和/或医疗护理,(3)利他主义,(4)金钱激励。
结论
针对特定人群的HIV疫苗试验招募和实施策略应从家庭角度、文化性别规范、不信任、感知到的HIV风险低、非裔美国人和拉丁裔/拉丁美洲人社区参与HIV疫苗试验的重要性以及对获得HIV感染防护的误解等方面来应对试验风险。提高试验招募和实施的文化相关性应有助于拉丁裔/拉丁美洲人和非裔美国人参与HIV疫苗试验。