1
|
Noorman MAJ, de Wit JBF, Marcos TA, Stutterheim SE, Jonas KJ, den Daas C. The Importance of Social Engagement in the Development of an HIV Cure: A Systematic Review of Stakeholder Perspectives. AIDS Behav 2023; 27:3789-3812. [PMID: 37329470 PMCID: PMC10589186 DOI: 10.1007/s10461-023-04095-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/19/2023]
Abstract
As research into the development of an HIV cure gains prominence, assessing the perspectives of stakeholders becomes imperative. It empowers stakeholders to determine priorities and influence research processes. We conducted a systematic review of the empirical literature on stakeholder perspectives. PubMed, Embase, Web of Science, and Scopus were searched for empirical, peer-reviewed articles, published before September 2022. Our analysis of 78 papers showed that stakeholders could be divided into three categories: people with HIV, key populations, and professionals. Following thematic synthesis, two main themes were distinguished: stakeholders' perspectives on HIV cure research and stakeholders' perspectives on HIV cure. Research on perspectives on HIV cure research showed that stakeholders' hypothetical willingness to participate (WTP) in HIV cure research was relatively high, while actual WTP was found to be lower. Studies also identified associated (individual) characteristics of hypothetical WTP, as well as facilitators and barriers to hypothetical participation. Additionally, we reported research on experiences of actual HIV cure research participation. Our analysis of stakeholder perceptions of HIV cure showed that most stakeholders preferred a cure that could eliminate HIV and outlined positive associated impacts. Furthermore, we observed that most included studies were conducted among PWHIV, and in the Global North. To empower stakeholders, we recommend that future research include an even greater diversity of stakeholders and incorporate theories of behavior to further explore how stakeholders decide to meaningfully engage in every stage of HIV cure research.
Collapse
Affiliation(s)
- Maaike A J Noorman
- Department of Interdisciplinary Social Science, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands.
| | - John B F de Wit
- Department of Interdisciplinary Social Science, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Tamika A Marcos
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Sarah E Stutterheim
- Department of Health Promotion and Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Kai J Jonas
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Chantal den Daas
- Institute of Applied Health Sciences, Health Psychology Group, University of Aberdeen, Aberdeen, UK
| |
Collapse
|
2
|
The perceived impact of an HIV cure by people living with HIV and key populations vulnerable to HIV in the Netherlands: A qualitative study. J Virus Erad 2022; 8:100066. [PMID: 35280938 PMCID: PMC8907669 DOI: 10.1016/j.jve.2022.100066] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/31/2022] [Accepted: 02/22/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction When an HIV cure becomes available, it will have consequences for people living with HIV (PLHIV) and key populations who are vulnerable to HIV. This qualitative study aimed to explore the perceived impact of two HIV cure scenarios (post-treatment control when HIV is suppressed without the need for ongoing antiretroviral treatment (ART) and complete HIV elimination) on the quality of life of PLHIV and key populations living without HIV in the Netherlands. Methods Participants were purposefully sampled from the Amsterdam Cohort Studies, the AGEhIV Cohort Study, the outpatient clinic of the University Medical Centre Utrecht and the Dutch HIV Association to increase variability. Semi-structured in-depth interviews were conducted between October 2020 and March 2021 and thematically analysed. Results Of the 42 interviewed participants, 29 were PLHIV and 13 represented key populations (i.e., men who have sex with men and people injecting drugs). Both PLHIV and participants from vulnerable key populations hoped that a cure would result in normalization of their lives by removing the need to disclose HIV, reducing stigma and guilt, increasing independence of ART, and liberating sexual behaviour. Both groups believed only HIV elimination could accomplish this desired impact. Conclusions While the post-treatment control scenario seems a more plausible outcome of current HIV cure research, our findings highlight that participants may not perceive it as a true cure. Involvement of PLHIV and vulnerable key populations in devising acceptable and feasible experimental approaches to HIV cure is essential to ensure their future successful implementation.
Collapse
|
3
|
Lewin SR, Attoye T, Bansbach C, Doehle B, Dubé K, Dybul M, SenGupta D, Jiang A, Johnston R, Lamplough R, McCune JM, Nabel GJ, Ndung'u T, Pottage J, Ripin D, Rooney JF, Sikazwe I, Nsubuga M, Warren M, Deeks SG. Multi-stakeholder consensus on a target product profile for an HIV cure. Lancet HIV 2021; 8:e42-e50. [PMID: 33271125 PMCID: PMC7773628 DOI: 10.1016/s2352-3018(20)30234-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/09/2020] [Accepted: 08/11/2020] [Indexed: 06/12/2023]
Abstract
Developing a cure for HIV is a global priority. Target product profiles are a tool commonly used throughout the drug development process to align interested parties around a clear set of goals or requirements for a potential product. Three distinct therapeutic modalities (combination therapies, ex-vivo gene therapy, and in-vivo gene therapy) for a target product profile for an HIV cure were identified. Using a process of expert face-to-face consultation and an online Delphi consultation, we found a high degree of agreement regarding the criteria for the optimum target product profile. Although the minimum attributes for a cure were debated, the broad consensus was that an acceptable cure need not be as safe and effective as optimally delivered antiretroviral therapy. An intervention that successfully cured a reasonable fraction of adults would be sufficient to advance to the clinic. These target product profiles will require further discussion and ongoing revisions as the field matures.
Collapse
Affiliation(s)
- Sharon R Lewin
- The Peter Doherty Institute for Infection and Immunity, The University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia; Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, VIC, Australia; Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, VIC, Australia.
| | - Timothy Attoye
- Department of Global Health, University of Washington, The Bill & Melinda Gates Foundation, Seattle, WA, USA
| | | | - Brian Doehle
- HIV Frontiers, Global Health Innovative Technology Solutions, The Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Karine Dubé
- University North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Mark Dybul
- Center for Global Health Practice and Impact, Georgetown University, Washington, DC, USA
| | | | - Adam Jiang
- McKinsey & Company Secondee at The Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Rowena Johnston
- amfAR, The Foundation for AIDS Research, New York City, NY, USA
| | | | - Joseph M McCune
- HIV Frontiers, Global Health Innovative Technology Solutions, The Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Gary J Nabel
- Sanofi Global Research and Development, Cambridge, MA, USA
| | - Thumbi Ndung'u
- Africa Health Research Institute, Durban, South Africa; HIV Pathogenesis Programme, The Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa; Max Planck Institute for Infection Biology, Berlin, Germany; Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA; Division of Infection and Immunity, University College London, London, UK
| | | | - David Ripin
- Clinton Health Access Initiative, Boston, MA, USA
| | | | - Izukanji Sikazwe
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Moses Nsubuga
- Joint Adherent Brothers & Sisters against AIDS, Kampala, Uganda
| | | | | |
Collapse
|
4
|
Sauceda JA, Dubé K, Brown B, Pérez AE, Rivas CE, Evans D, Fisher CB. Framing a Consent Form to Improve Consent Understanding and Determine How This Affects Willingness to Participate in HIV Cure Research: An Experimental Survey Study. J Empir Res Hum Res Ethics 2020; 16:78-87. [PMID: 33307932 DOI: 10.1177/1556264620981205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
HIV cure research carries serious risks and negligible benefits. We investigated how participants understand these risks and what influences their willingness to participate. Through internet-based and in-person convenience sampling, 86 HIV+ participants completed an experimental survey. Participants were randomized to read a standard consent form describing a hypothetical HIV cure study or one adapted using Fuzzy Trace Theory-a decision-making model to facilitate complex information processing. We measured consent understanding and cognitive (e.g., safe/harmful) and affective (e.g., concerning, satisfying) evaluations of HIV cure research. Participants who read the adapted consent form had improved consent understanding, but only positive affective evaluations were associated with a willingness to participate. Consent processes can use decision-making theories to facilitate comprehension of study information.
Collapse
Affiliation(s)
| | - Karine Dubé
- 2331University of North Carolina Chapel Hill, USA
| | | | | | | | - David Evans
- 455669Delaney AIDS Research Enterprise Martin Delaney Collaboratory Community Advisory Board, San Francisco, CA, USA
| | | |
Collapse
|
5
|
da Silva JG, Silva CS, Alexandre B, Morgado P. Health Literacy of the Inland Population in Mitigation Phase 3.2 of the COVID-19 Pandemic in Portugal: A Descriptive Cross-Sectional Study. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2020. [PMCID: PMC7801966 DOI: 10.1159/000511216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background COVID-19 is a respiratory disease transmitted through respiratory droplets and has a high transmission rate. There is still no effective and approved antiretroviral treatment or vaccine, so preventative measures remain the key to contain this pandemic. Portugal is now in phase 3.2 of the mitigation of COVID-19, with it being imperative to understand the health literacy of our country and prevent a lack of information through community empowerment. Material and Methods A cross-sectional study with a sample from a primary care facility was conducted. We collected demographic and epidemiological data and carried out a questionnaire by phone call. Descriptive statistics and nonparametric tests were used to assess associations between the independent variables and the level of health literacy. The level of significance was set at p < 0.05. Results Our sample included 222 subjects (median age 62 years), mostly females (n = 131), undergraduates (n = 193), and with at least 1 risk factor for COVID-19 (n = 144). Overall, younger individuals, females, graduates and the nonrisk group appeared to have higher levels of health literacy, with some exceptions. Conclusions We observed a well-informed population. However, it being a pandemic situation, our intention was to identify and correct outliers/misconceptions. This work allowed a perspective of the current state/pattern of health literacy as well as its possible predictors. Furthermore, it raised awareness of the relevance of specific communication approaches. Further studies to understand the predictors of health literacy are necessary.
Collapse
Affiliation(s)
- Joana Gomes da Silva
- Centro de Saúde Mirandela II, Unidade Local de Saúde do Nordeste, Mirandela, Portugal
- *Joana Gomes da Silva, Centro de Saúde Mirandela II, Unidade Local de Saúde do Nordeste, Rua Santa Catarina, PT–5370-359 Mirandela (Portugal),
| | - Carla Sofia Silva
- Alumni Department of Mathematics, University of Minho, Braga, Portugal
| | - Bárbara Alexandre
- Centro de Saúde Mirandela II, Unidade Local de Saúde do Nordeste, Mirandela, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| |
Collapse
|
6
|
Fridman I, Fagerlin A, Scherr KA, Scherer LD, Huffstetler H, Ubel PA. Gain-loss framing and patients' decisions: a linguistic examination of information framing in physician-patient conversations. J Behav Med 2020; 44:38-52. [PMID: 32725580 DOI: 10.1007/s10865-020-00171-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 07/16/2020] [Indexed: 12/25/2022]
Abstract
When discussing risks and benefits with cancer patients, physicians could focus on losses such as mortality rates and cancer recurrence or, alternatively, gains such as survival rates and curing cancer. Previous research has shown that the way health information is framed influences individuals' preferences and choices. We operationalized gain-loss framing as physicians' choice of words related to gains (cancer survival), or losses (cancer mortality). In an exploratory analysis, we investigated (a) whether physicians used gain or loss words as a function of their recommendation, (b) whether physicians' choice of words was associated with patients' treatment choices. We analyzed transcribed consultations with male patients who had intermediate-risk prostate cancer. Using an iterative process of gathering and evaluating words, we created gain- and loss-dictionaries. The loss-dictionary included words related to cancer death and cancer progression. The gain-dictionary included words related to survival and cure. Using Linguistic Inquiry and Word Count software, we calculated the number of words related to gains and losses in each transcript. We found that physicians who recommended immediate cancer treatment for prostate cancer (vs. active surveillance) used slightly fewer words related to losses and significantly fewer words related specifically to death from cancer. Further analysis showed that loss words were associated with the patient's choice of immediate cancer treatment. A novel method of automated text analysis showed that physicians' use of loss words was correlated with physicians' recommendations for cancer treatment versus active surveillance. Additionally, loss words in consultations were associated with patients' choice of cancer treatment.
Collapse
Affiliation(s)
- Ilona Fridman
- Fuqua School of Business, Duke University, 100 Fuqua Drive, Durham, NC, 27708, USA. .,Duke Margolis Center for Health Policy, Duke University, Durham, NC, 27708, USA.
| | - Angela Fagerlin
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, UT, USA.,Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA
| | - Karen A Scherr
- Family Medicine and Community Health, Duke School of Medicine, Durham, NC, USA
| | - Laura D Scherer
- Adult and Child Consortium of Health Outcomes Research and Delivery Science (ACCORDS), Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA.,Center of Innovation for Veteran-Centered and Value-Driven Care, VA Denver, Denver, CO, USA
| | - Hanna Huffstetler
- Fuqua School of Business, Duke University, 100 Fuqua Drive, Durham, NC, 27708, USA
| | - Peter A Ubel
- Fuqua School of Business, Duke University, 100 Fuqua Drive, Durham, NC, 27708, USA.,Sanford School of Public Policy, Duke University, Durham, NC, USA.,Duke School of Medicine, Durham, NC, USA
| |
Collapse
|