Perceptions and Acceptance of a Prophylactic Vaccine for Human Immunodeficiency Virus (HIV): A Qualitative Study

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Abstract

Background

Despite advances in human immunodeficiency virus (HIV) prevention methods, such as the advent of pre-exposure prophylaxis (PrEP), the number of people with newly acquired HIV remains high, particularly in at-risk groups. A prophylactic HIV vaccine could contribute to reduced disease prevalence and future transmission and address limitations of existing options, such as suboptimal long-term adherence to PrEPs.

Methods

This qualitative study aimed to capture perceptions towards and acceptance of prophylactic HIV vaccination in three adult populations in the United States: the general population, ‘at-risk’ individuals (e.g. men who have sex with men, transgender individuals, gender-nonconforming individuals, and individuals in a sexual relationship with a person living with HIV), and parents/caregivers of children aged 9–17 years. Interviews were conducted with 55 participants to explore key drivers and barriers to HIV vaccine uptake, and a conceptual model was developed.

Results

The sample was diverse; participants were 51% female, aged 20–57 years (mean 37 years), 33% with high school diploma as highest education level, and identified as White (42%), Black or African American (35%), of Hispanic, Latino, or Spanish origin (22%), or other races/ethnicities (8%) [groupings are not mutually exclusive]. Perceptions were influenced by individual, interpersonal, community, institutional, and structural factors. Overall, 98% of participants thought vaccination would be beneficial in preventing HIV. Key considerations/barriers included perceived susceptibility, i.e. whether participants felt there was a risk of contracting HIV (discussed by 90%); the clinical profile of the vaccine (e.g. the adverse effect profile [98%], and vaccine efficacy [85%], cost [73%] and administration schedule [88%]); and concerns around potential vaccine-induced seropositivity (VISP; 62%). Stigma was not found to be an important barrier, with a general view that vaccination status was personal. Participants in the ‘at-risk’ group were the most likely to accept an HIV vaccine (70%). Unique concerns in the subgroups included how a potential vaccine’s clinical profile compared with PrEP, voiced by those receiving/considering PrEP, and considerations of children’s views on the topic, voiced by parents/caregivers.

Conclusions

Understanding these factors could help develop HIV vaccine research strategies and contribute toward public health messaging to support future HIV vaccination programs.

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对人类免疫缺陷病毒(HIV)预防性疫苗的看法和接受程度:定性研究
摘要 背景 尽管人类免疫缺陷病毒(HIV)预防方法取得了进步,例如出现了暴露前预防疗法(PrEP),但新感染 HIV 的人数仍然居高不下,尤其是在高危人群中。预防性艾滋病疫苗有助于减少疾病的流行和未来的传播,并能解决现有方案的局限性,如 PrEPs 的长期依从性不理想。 方法 本定性研究旨在了解美国三个成年人群体对预防性 HIV 疫苗接种的看法和接受程度:普通人群、"高危 "人群(如男男性行为者、变性人、性别不一致者、与 HIV 感染者有性关系者)以及 9-17 岁儿童的父母/监护人。我们对 55 名参与者进行了访谈,以探讨艾滋病疫苗接种的主要驱动因素和障碍,并建立了一个概念模型。 结果 样本具有多样性;51% 的参与者为女性,年龄在 20-57 岁之间(平均 37 岁),33% 的参与者最高学历为高中毕业文凭,并被认定为白人(42%)、黑人或非裔美国人(35%)、西班牙裔、拉美裔或西班牙血统(22%)或其他种族/民族(8%)[分组并不相互排斥]。个人、人际、社区、机构和结构性因素影响了人们的看法。总体而言,98% 的参与者认为接种疫苗有利于预防 HIV。主要考虑因素/障碍包括感知易感性,即参与者是否认为有感染 HIV 的风险(90% 的人讨论过);疫苗的临床概况(如不良反应概况 [98%]、疫苗疗效 [85%]、成本 [73%] 和接种时间 [88%]);以及对潜在的疫苗诱导血清阳性反应 (VISP; 62%) 的担忧。人们普遍认为接种疫苗是个人行为,因此污名化并不是一个重要的障碍。高危 "组的参与者最有可能接受艾滋病毒疫苗(70%)。亚组中的独特关注点包括潜在疫苗的临床概况与 PrEP 的比较(由接受/考虑 PrEP 者提出),以及儿童对该主题的看法(由父母/照顾者提出)。 结论 了解这些因素有助于制定艾滋病疫苗研究策略,并有助于传播公共卫生信息,支持未来的艾滋病疫苗接种计划。
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