Alexander Andreia B, Ott Mary A, Lally Michelle A, Sniecinski Kevin, Baker Alyne, Zimet Gregory D
Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, United States.
Department of Medicine, Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, United States.
Vaccine. 2015 Mar 10;33(11):1331-7. doi: 10.1016/j.vaccine.2015.01.049. Epub 2015 Jan 30.
The purpose of this study was to examine the process of adolescent decision-making about participation in an HIV vaccine clinical trial, comparing it to adult models of informed consent with attention to developmental differences.
As part of a larger study of preventive misconception in adolescent HIV vaccine trials, we interviewed 33 male and female 16-19-year-olds who have sex with men. Participants underwent a simulated HIV vaccine trial consent process, and then completed a semistructured interview about their decision making process when deciding whether or not to enroll in and HIV vaccine trial. An ethnographic content analysis approach was utilized.
Twelve concepts related to adolescents' decision-making about participation in an HIV vaccine trial were identified and mapped onto Appelbaum and Grisso's four components of decision making capacity including understanding of vaccines and how they work, the purpose of the study, trial procedures, and perceived trial risks and benefits, an appreciation of their own situation, the discussion and weighing of risks and benefits, discussing the need to consult with others about participation, motivations for participation, and their choice to participate.
The results of this study suggest that most adolescents at high risk for HIV demonstrate the key abilities needed to make meaningful decisions about HIV vaccine clinical trial participation.
本研究旨在考察青少年关于参与HIV疫苗临床试验的决策过程,并将其与成人的知情同意模式进行比较,同时关注发育差异。
作为青少年HIV疫苗试验中预防性误解的一项更大规模研究的一部分,我们采访了33名16至19岁与男性发生性行为的青少年。参与者经历了一个模拟的HIV疫苗试验同意过程,然后完成了一项关于他们在决定是否参加HIV疫苗试验时的决策过程的半结构化访谈。采用了人种志内容分析方法。
确定了与青少年参与HIV疫苗试验决策相关的12个概念,并将其映射到阿佩尔鲍姆和格里索决策能力的四个组成部分上,包括对疫苗及其作用方式的理解、研究目的、试验程序以及感知到的试验风险和益处、对自身情况的认识、风险和益处的讨论与权衡、讨论是否需要就参与咨询他人、参与动机以及他们参与的选择。
本研究结果表明,大多数有HIV感染高风险的青少年具备就参与HIV疫苗临床试验做出有意义决策所需的关键能力。