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艾滋病毒疫苗试验参与的潜在危害和益处感知:来自坦桑尼亚城市的定性研究。

Perception of potential harm and benefits of HIV vaccine trial participation: A qualitative study from urban Tanzania.

机构信息

Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

出版信息

PLoS One. 2019 Nov 8;14(11):e0224831. doi: 10.1371/journal.pone.0224831. eCollection 2019.

Abstract

BACKGROUND

The development of an effective preventive HIV vaccine is the best-known option to halt incident HIV infections. Participants in HIV vaccine trials may possess expectations shaped by existing socio-cultural contexts that are important to understand to allow for improved trial design. Here, we describe post-phase I/II HIV vaccine trial perceptions within participating communities in Dar es Salaam, Tanzania.

MATERIALS AND METHODS

This descriptive qualitative study was conducted in May 2016. We conducted eight focus group discussions, each consisting of 5 to 12 participants. Four groups comprised of the past phase I/II HIV vaccine trial participants and four groups involved those who did not participate. We used a thematic analysis approach.

RESULTS

Ongoing concerns existed among non-vaccine trial participants who believed that those who participated in HIV vaccine trials were infected with HIV. Limited post-HIV vaccine trial result dissemination, the pre-existing negative beliefs about vaccines, and experiences from other previous medical experiments fueled these concerns. The participants anticipated that broader dissemination of facts regarding HIV vaccine trials using media, former volunteers, and flyers would reduce the reported concerns. In contrast, some participants embraced the benefits gained through participating in HIV vaccine trials. HIV vaccine trial participants appreciated trial interventions, such as health status check-ups, knowledge acquisition, and facilitation of access to medical services. They envisioned mutual benefits in the form of community protection and capacity building among the local scientists.

CONCLUSIONS

The future conduct of HIV vaccine trials in Tanzania requires wider community dissemination of information and post-trial feedback to alleviate concerns among the participating communities. Interventions such as medical services may represent essential incentives to the HIV vaccine trial volunteers. In future HIV vaccine trials, it is crucial to boost individual and perceived mutual benefits.

摘要

背景

开发有效的预防性 HIV 疫苗是阻止新的 HIV 感染的最佳选择。HIV 疫苗试验的参与者可能具有由现有社会文化背景塑造的期望,这些期望对于理解参与者的期望以改进试验设计很重要。在这里,我们描述了在坦桑尼亚达累斯萨拉姆的 I/II 期 HIV 疫苗试验参与社区中的试验后认知。

材料与方法

这是一项描述性的定性研究,于 2016 年 5 月进行。我们进行了八次焦点小组讨论,每次讨论由 5 至 12 名参与者组成。其中四个小组由过去参加过 I/II 期 HIV 疫苗试验的参与者组成,另外四个小组则由未参加过试验的参与者组成。我们使用主题分析方法。

结果

未参加疫苗试验的参与者持续存在一些担忧,他们认为那些参加 HIV 疫苗试验的人感染了 HIV。有限的 HIV 疫苗试验结果传播、对疫苗的固有负面信念以及其他先前医学实验的经验助长了这些担忧。参与者预计,通过媒体、前志愿者和传单更广泛地传播有关 HIV 疫苗试验的事实,将减少报告的担忧。相比之下,一些参与者接受了通过参加 HIV 疫苗试验获得的好处。HIV 疫苗试验参与者欣赏试验干预措施,例如健康状况检查、知识获取和促进获得医疗服务。他们设想在当地科学家之间以社区保护和能力建设的形式实现互惠互利。

结论

未来在坦桑尼亚进行 HIV 疫苗试验需要更广泛地向社区传播信息和试验后反馈,以减轻参与社区的担忧。医疗服务等干预措施可能是 HIV 疫苗试验志愿者的重要激励因素。在未来的 HIV 疫苗试验中,重要的是要提高个人和感知到的共同利益。

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