Setshaba Research Centre, Pretoria, South Africa; Synergy Biomed Research Institute, East London, South Africa.
Setshaba Research Centre, Pretoria, South Africa.
S Afr Med J. 2022 Dec 20;113(1):36-41. doi: 10.7196/SAMJ.2023.v113i1.16670.
The high HIV prevalence and incidence in South Africa makes it suitable for recruitment of participants for large-scale HIV preventive vaccine trials. However, fear of vaccine-induced seropositivity (VISP) may be a barrier for community acceptability of the trial, for volunteers to participate in HIV preventive vaccine trials and for uptake of an efficacious vaccine. Prior to 2015, when the first phase 1 safety HIV vaccine trial was undertaken at Setshaba Research Centre, Soshanguve, the local community stakeholders and healthcare workers were naive about HIV vaccine research and HIV preventive vaccines.
To explore knowledge and perceptions regarding VISP among community stakeholders and healthcare workers in peri-urbanb Soshanguve, Tshwane.
Using a quantitative-qualitative mixed-methods study design, surveys (n=50) and in-depth interviews (n=18) were conducted during July - August 2015. Participants included community stakeholders, community advisory board members and healthcare workers, who were >18 years old and had attended community educational workshops during September 2014 - May 2015. Audio recordings of interviews were transcribed verbatim and coded using content thematic analysis. Data were further analysed by sex, age and educational level.
Of a maximum score of 2 on knowledge on VISP, the 50 survey participants (mean age 33.78 years; 45 females) obtained an average of 0.88 (44%). Of 17 in-depth interviewees (one interview could not be transcribed; mean age 30.9 years; 12 females), 8 (47%) displayed some knowledge about VISP, of whom only 5 defined VISP correctly. Women were more knowledgeable about VISP than men; 5 of 12 women (42%) came close to defining VISP correctly, while none of the 5 men did so. The main fear of trial participation expressed by most participants (n=6) was testing HIV-positive as a result of the vaccine. While some participants believed that the community's perceptions of VISP would negatively affect HIV vaccine trial support and recruitment efforts, others noted that if trial participants understand the concept of VISP and are part of support groups, then they would have the information to combat negative attitudes within their community.
Most participants had an inaccurate and incomplete understanding of VISP. Many feared testing HIV-positive at clinics; therefore, education on improving a basic understanding of how vaccines work and why VISP occurs is essential. In addition, assessing participant understanding of HIV testing, transmission and VISP is critical for recruitment of participants into HIV vaccine trials and may improve acceptability of an HIV preventive vaccine.
南非的 HIV 高流行率和发病率使其适合招募大量 HIV 预防性疫苗试验的参与者。然而，对疫苗诱导血清阳性（VISP）的恐惧可能是社区对试验可接受性、志愿者参与 HIV 预防性疫苗试验以及接受有效疫苗的一个障碍。在 2015 年之前，当第一阶段 1 安全 HIV 疫苗试验在 Soshanguve 的 Setshaba 研究中心进行时，当地社区利益攸关方和医疗保健工作者对 HIV 疫苗研究和 HIV 预防性疫苗一无所知。
探讨 peri-urbanb Soshanguve 社区利益攸关方和医疗保健工作者对 VISP 的知识和看法。
使用定量-定性混合方法研究设计，在 2015 年 7 月至 8 月期间进行了调查（n=50）和深入访谈（n=18）。参与者包括社区利益攸关方、社区咨询委员会成员和医疗保健工作者，年龄大于 18 岁，并在 2014 年 9 月至 2015 年 5 月期间参加了社区教育研讨会。访谈的音频记录被逐字转录，并使用内容主题分析进行编码。数据进一步按性别、年龄和教育水平进行分析。
在 VISP 知识的最高得分为 2 分的情况下，50 名调查参与者（平均年龄 33.78 岁；45 名女性）的平均得分为 0.88（44%）。在 17 名深入访谈者中（一次访谈无法转录；平均年龄 30.9 岁；12 名女性），有 8 名（47%）对 VISP 有一定的了解，其中只有 5 名正确定义了 VISP。女性对 VISP 的了解程度高于男性；12 名女性中有 5 名（42%）接近正确定义 VISP，而 5 名男性中没有一人这样做。大多数参与者（n=6）表示，参加试验的主要担忧是由于疫苗而检测出 HIV 阳性。虽然一些参与者认为社区对 VISP 的看法会对 HIV 疫苗试验的支持和招募工作产生负面影响，但其他人指出，如果试验参与者了解 VISP 的概念并成为支持小组的一部分，那么他们将有信息来对抗社区内部的负面态度。
大多数参与者对 VISP 的理解不准确且不完整。许多人担心在诊所检测出 HIV 阳性；因此，必须加强教育，提高对疫苗如何发挥作用以及 VISP 为何发生的基本理解。此外，评估参与者对 HIV 检测、传播和 VISP 的理解对于招募 HIV 疫苗试验参与者至关重要，并且可能提高对 HIV 预防性疫苗的可接受性。
