Doshi Monika, Avery Lisa, Kaddu Ronnie P, Gichuhi Mary, Gakii Gloria, du Plessis Elsabé, Dutta Sumit, Khan Shamshad, Kimani Joshua, Lorway Robert R
The Centre for Global Public Health, University of Manitoba, Community Health Sciences, R070 Med Rehab Bldg, 771 McDermot Avenue, Winnipeg, R3E0T6, Canada.
Saath, 50 South Highland Street, West Hartford, CT, 06119, USA.
BMC Public Health. 2017 May 18;17(1):469. doi: 10.1186/s12889-017-4395-4.
The HIV epidemic among men who have sex with men (MSM) continues to expand globally. The addition of an efficacious, prophylactic vaccine to combination prevention offers immense hope, particularly in low- and middle- income countries which bear the greatest global impact. However, in these settings, there is a paucity of vaccine preparedness studies that specifically pertain to MSM. Our study is the first vaccine preparedness study among MSM and female sex workers (FSWs) in Kenya. In this paper, we explore willingness of Kenyan MSM to participate in HIV vaccine efficacy trials. In addition to individual and socio-cultural motivators and barriers that influence willingness to participate (WTP), we explore the associations or linkages that participants draw between their experiences with or knowledge of medical research both generally and within the context of HIV/AIDS, their perceptions of a future HIV vaccine and their willingness to participate in HIV vaccine trials.
Using a social network-based approach, we employed snowball sampling to recruit MSM into the study from Kisumu, Mombasa, and Nairobi. A field team consisting of seven community researchers conducted in-depth interviews with a total of 70 study participants. A coding scheme for transcribed and translated data was developed and the data was then analysed thematically.
Most participants felt that an HIV vaccine would bring a number of benefits to self, as well as to MSM communities, including quelling personal fears related to HIV acquisition and reducing/eliminating stigma and discrimination shouldered by their community. Willingness to participate in HIV vaccine efficacy trials was highly motivated by various forms of altruism. Specific researcher responsibilities centred on safe-guarding the rights and well-being of participants were also found to govern WTP, as were reflections on the acceptability of a future preventive HIV vaccine.
Strategies for engagement of communities and recruitment of trial volunteers for HIV vaccine efficacy trials should not only be grounded in and informed by investigations into individual and socio-cultural factors that impact WTP, but also by explorations of participants' existing experiences with or knowledge of medical research as well as attitudes and acceptance towards a future HIV vaccine.
男男性行为者（MSM）中的艾滋病毒流行在全球范围内持续蔓延。在联合预防措施中加入一种有效的预防性疫苗带来了巨大希望，尤其是在受全球影响最大的低收入和中等收入国家。然而，在这些环境中，专门针对男男性行为者的疫苗准备研究很少。我们的研究是肯尼亚首次针对男男性行为者和女性性工作者（FSW）开展的疫苗准备研究。在本文中，我们探讨了肯尼亚男男性行为者参与艾滋病毒疫苗疗效试验的意愿。除了影响参与意愿（WTP）的个人和社会文化动机及障碍外，我们还探讨了参与者在一般医学研究以及艾滋病毒/艾滋病背景下的经历或知识、他们对未来艾滋病毒疫苗的看法与他们参与艾滋病毒疫苗试验意愿之间的关联或联系。
我们采用基于社交网络的方法，通过滚雪球抽样从基苏木、蒙巴萨和内罗毕招募男男性行为者参与研究。一个由七名社区研究人员组成的实地团队对总共70名研究参与者进行了深入访谈。针对转录和翻译后的数据制定了编码方案，然后对数据进行了主题分析。
大多数参与者认为，艾滋病毒疫苗将给自身以及男男性行为者群体带来诸多益处，包括消除与感染艾滋病毒相关的个人恐惧，以及减少/消除其群体所承受的耻辱和歧视。各种形式的利他主义是参与艾滋病毒疫苗疗效试验意愿的强大动力。还发现，以保障参与者权利和福祉为核心的特定研究人员职责以及对未来预防性艾滋病毒疫苗可接受性的思考也影响参与意愿。
艾滋病毒疫苗疗效试验的社区参与策略和试验志愿者招募策略不仅应以对影响参与意愿的个人和社会文化因素的调查为基础并从中获取信息，还应以对参与者现有医学研究经历或知识以及对未来艾滋病毒疫苗的态度和接受程度的探索为依据。
