McClarty Leigh M, Lorway Robert R, Ramanaik Satyanarayana, Wylie John, Becker Marissa L
Centre for Global Public Health, Department of Community Health Sciences, University of Manitoba, R070 Medical Rehabilitation Building, 771 McDermot Avenue, Winnipeg, Manitoba R3E 0T6, Canada.
Karnataka Health Promotion Trust, IT Park, #1-4, 5th Floor, Rajajinagar Industrial Area, Rajajinagar, Bangalore, 560044, India.
Vaccine. 2015 Jan 29;33(5):656-63. doi: 10.1016/j.vaccine.2014.12.009. Epub 2014 Dec 17.
The HIV epidemic in the south Indian state of Karnataka disproportionately burdens key populations of men who have sex with men and female sex workers. Despite having successfully reduced HIV incidence among certain key populations through the use of targeted intervention, India's HIV epidemic remains one of its greatest public health issues. The best long-term strategy for managing the global HIV epidemic might involve a preventive vaccine; however, vaccine availability cannot guarantee its accessibility or acceptability. Vaccine recommendations from frontline health service providers have previously been identified as useful strategies to enhance vaccine uptake among target groups. This study used structured interviews to explore frontline health service providers' self-identified likelihood to recommend a future, preventive HIV vaccine to key populations in Karnataka. A modified social ecological model was then used to categorise factors that might prevent health service providers from recommending an HIV vaccine. Overall, 83% of health service providers reported that they would be very likely to recommend an HIV vaccine to men who have sex with men and female sex workers, while less than one-third of participants identified one or more barrier to vaccine recommendation. Intrapersonal, interpersonal, and structural/political factors were most commonly reported to act as potential barriers to future HIV vaccine recommendation among health service providers in Karnataka. This study adds to the limited body of literature focussing on future HIV vaccine acceptability in low- and middle-income countries and highlights some of the several complexities surrounding vaccine acceptability and uptake among key populations in Karnataka.
印度南部卡纳塔克邦的艾滋病疫情给男男性行为者和女性性工作者等重点人群带来了格外沉重的负担。尽管通过有针对性的干预措施成功降低了某些重点人群中的艾滋病发病率，但印度的艾滋病疫情仍是其最严峻的公共卫生问题之一。应对全球艾滋病疫情的最佳长期策略可能是研制预防性疫苗；然而，疫苗的可获得性并不能保证其可及性或可接受性。此前已确定，一线卫生服务提供者给出的疫苗建议是提高目标群体疫苗接种率的有效策略。本研究通过结构化访谈，探讨一线卫生服务提供者自行认定的向卡纳塔克邦重点人群推荐未来预防性艾滋病疫苗的可能性。随后使用经过改进的社会生态模型，对可能阻碍卫生服务提供者推荐艾滋病疫苗的因素进行分类。总体而言，83%的卫生服务提供者报告称，他们极有可能向男男性行为者和女性性工作者推荐艾滋病疫苗，而不到三分之一的参与者指出了一项或多项阻碍疫苗推荐的因素。在卡纳塔克邦的卫生服务提供者中，个人、人际以及结构/政治因素最常被报告为未来艾滋病疫苗推荐的潜在障碍。本研究补充了聚焦于低收入和中等收入国家未来艾滋病疫苗可接受性的有限文献，并凸显了卡纳塔克邦重点人群在疫苗可接受性和接种方面存在的若干复杂情况。
