Young men who have sex with men's awareness, acceptability, and willingness to participate in HIV vaccine trials: Results from a nationwide online pilot study

Vaccination uptake in LGBTQ adults in two US states: Findings from the QVax study

OBJECTIVES

Lesbian, gay, bisexual, transgender, queer and other (LGBTQ+) individuals face numerous health disparities, including higher rates of chronic diseases and sexually transmitted infections, partly due to marginalization, discrimination, and a healthcare system often unprepared to meet their specific needs. Despite the importance of vaccination in preventing these health issues, vaccination patterns in LGBTQ+ populations remain under-researched, with limited data available due to the absence of sexual orientation and gender identity information on most healthcare forms. As such, we sought to understand vaccine uptake among LGBTQ+ individuals living in New Jersey and New York for 7 primary adult vaccines.

METHODS

Participants were 768 LGBTQ+ adults living in New Jersey and New York, US. We recruited this convenience sample through community centers and events, social media, and listservs of local professional organizations. The online survey examined uptake for 7 adult vaccines.

RESULTS

Of the 7 adult vaccines, human papilloma virus (HPV) had the lowest proportion of participants who were fully/partially vaccinated (54.4 %), followed by hepatitis A (59.8 %), hepatitis B (63.0 %), meningitis B (63.7 %), seasonal influenza during the COVID-19 pandemic (70.2 %), seasonal influenza before the COVID-19 pandemic (70.3 %), and nearly all participants (99.2 %) received at least one dose of the COVID-19 vaccine. For Shingles virus, among participants age 50+, 63.8 % were fully/partially vaccinated. In adjusted models, age was the strongest predictor of vaccination uptake in HPV, hepatitis A, hepatitis B, meningitis B, and seasonal influenza before and during the COVID-19 pandemic. Younger participants were more likely to be vaccinated for 4 of the 6 vaccines, excluding Shingles (<0.001), whereas older adults were more likely to be vaccinated for seasonal influenza before and during the COVID-19 pandemic (<0.010).

CONCLUSIONS

This study highlights the differences in uptake across different vaccines. It also draws attention to differences within LGBTQ+ populations which is important to consider when ensuring more equitable vaccine access.

Acceptability, facilitators, and barriers to a hypothetical HIV vaccine in the pre-exposure prophylaxis era

Little is known about the pre-implementation context for a preventive HIV vaccine. We conducted interviews of individuals in Philadelphia recruited at Penn clinics and community-based organizations serving LGBTQ-identifying persons of color who 1) were cisgender men who had sex with men, or were transgender-identified, 2) had a sexually transmitted infection in the last 12 months, or sex with multiple partners within the last two weeks. We assessed acceptability, facilitators, and barriers to a hypothetical HIV vaccine using an integrated analysis approach. We interviewed 30 individuals between 2/2023-9/2023. Participants were supportive of an HIV vaccine and reported that they would strongly consider receiving one if one became available. Participants contextualized a hypothetical vaccine with the current HIV prevention context, primarily pre-exposure prophylaxis (PrEP), indicating that they would evaluate any future vaccine in comparison to their experience within the PrEP landscape.Reported facilitators for a hypothetical HIV vaccine included vaccine access, knowledge, and understanding; their risk for HIV exposure; and perceived benefits of the vaccine. Barriers included lack of understanding of the purpose of a vaccine, stigma surrounding HIV and sexual practices that may surface towards people who seek vaccination, and potential issues with effectiveness, side effects, or lack of availability.

Acceptability of a Future HIV Vaccine: A Rapid Scoping Review

BACKGROUND

A HIV vaccine is not available yet, but perceptions of HIV vaccines will be important to explore before their roll-out for effective vaccine promotion. This article presents the findings of a rapid scoping review of the literature to identify individual, social, and vaccine-related factors associated with the acceptability of a future HIV vaccine.

METHODS

We searched 5 databases (Medline OVID, Embase, PsycINFO, Web of Science, and Cochrane) using relevant keywords and Medical Subject Headings. All articles, regardless of study design, publication year, and geographic location, were included if they examined HIV vaccine acceptability and its underlying factors.

RESULTS

We retrieved 2386 unique articles, of which 76 were included in the final review. Perceived benefits (34.2%) and perceived susceptibility (25.0%) were primary individual factors of HIV vaccine acceptability. Misinformation (17.1%) and distrust (22.4%) regarding future HIV vaccines, HIV stigma (30.3%), and social support (10.5%) were social factors of HIV vaccine acceptability. Vaccine efficacy (42.1%), cost (28.9%), and side effects (67.1%) were common vaccine characteristics influencing HIV vaccine acceptability. Altruism (10.5%) and risk compensation (26.3%) were also key factors.

CONCLUSIONS

Our analyses revealed that skeptical beliefs, negative perceptions, and misconceptions about HIV vaccines are real barriers to their acceptability. To alleviate HIV vaccine hesitancy and address trust concerns, strategic vaccine communication should be disseminated by trustworthy sources. Messages should impart accurate vaccine information and emphasize both individual and social benefits of HIV vaccination, as well as leverage social support in increasing willingness to get a future HIV vaccine.

Influences on clinical trial participation: Enhancing recruitment through a gender lens - A scoping review

Background

Suboptimal clinical trial recruitment contributes to research waste. Evidence suggests there may be gender-based differences in willingness to participate in clinical research. Identifying gender-based differences impacting the willingness of trial participation may assist trial recruitment.

Objectives

To examine factors that influence the willingness of men and women to participate in clinical trials and to identify modifiable factors that may be targeted to optimise trial participation.

Material and methods

Electronic databases were searched with key words relating to 'gender', 'willingness to participate' and 'trial'. Included studies were English language and reported gender-based differences in willingness to participate in clinical trials, or factors that influence a single gender to participate in clinical trials. Studies were excluded if they described the demographic factors of trial participants or if the majority of participants were pregnant. Extracted data were coded, categorized, analysed thematically and interpreted using Arksey and O'Malley's framework.

Results

Sixty-three studies were included. Two main themes were identified: trial characteristics and participant characteristics. A number of gender-based differences moderating willingness to participate were observed although only one, 'concern for self' was found to influence actual trial participation rates between genders.

Conclusion

The relationship between factors influencing willingness to participate in clinical trials is complex. The influence of gender on willingness to participate, while important, may be moderated by other factors including socioeconomic status, ethnicity and health condition. Exploring factors that influence willingness to participate specific to a study cohort likely offers the most promise to optimise trial recruitment of that cohort.

Preparing for future European efficacy trials of interventions to prevent HIV and other sexually transmitted infections: Lessons on willingness to participate and barriers to participation from ten German clinics serving behaviorally vulnerable men who have sex with men

Future efficacy testing of interventions to prevent HIV or other infections will require engagement of vulnerable populations. We characterized willingness to participate in a future HIV vaccine trial and barriers to participation among men who have sex with men in a 12-month German cohort study. Among 1015 participants at enrollment, 604 (60%) reported willingness, 60 (6%) were unwilling, 351 (35%) were unsure or refused to answer. Among those unwilling, the primary reason was fear of getting HIV. Among those willing, reasons included protection against HIV and furthering scientific knowledge. In a multivariable logistic regression model, higher odds of willingness to participate were seen among participants at the 12-month visit (aOR: 1.09, 95% CI: 1.04-1.15) and with prior knowledge of HIV vaccine research (aOR: 1.14, 95% CI: 1.06-1.23). Educating potential participants about vaccine research may facilitate recruitment and participation in future trials of HIV vaccine candidates and other prevention interventions.

Mining the vaccination willingness of China using social media data

OBJECTIVE

Vaccination is one of the most powerful and effective protective measures against Coronavirus disease 2019 (COVID-19). Currently, several blogs hold content on vaccination attitudes expressed on social media platforms, especially Sina Weibo, which is one of the largest social media platforms in China. Therefore, Weibo is a good data source for investigating public opinions about vaccination attitudes. In this paper, we aimed to effectively mine blogs to quantify the willingness of the public to get the COVID-19 vaccine.

MATERIALS AND METHODS

First, data including 144,379 Chinese blogs from Weibo, were collected between March 24 and April 28, 2021. The data were cleaned and preprocessed to ensure the quality of the experimental data, thereby reducing it to an experimental dataset of 72,496 blogs. Second, we employed a new fusion sentiment analysis model to analyze the sentiments of each blog. Third, the public's willingness to get the COVID-19 vaccine was quantified using the organic fusion of sentiment distribution and information dissemination effect.

RESULTS

(1) The intensity of bloggers' sentiment toward COVID-19 vaccines changed over time. (2) The extremum of positive and negative sentiment intensities occurred when hot topics related to vaccines appeared. (3) The study revealed that the public's willingness to get the COVID-19 vaccine and the actual vaccination doses shares a linear relationship.

CONCLUSION

We proposed a method for quantifying the public's vaccination willingness from social media data. The effectiveness of the method was demonstrated by a significant consistency between the estimates of public vaccination willingness and actual COVID-19 vaccination doses.

Young adult preference analysis on the attributes of COVID-19 vaccine in the Philippines: A conjoint analysis approach

Objective

Vaccines are utilized to prevent the severity of illnesses like the COVID-19 virus. Currently, there are a lot of COVID-19 vaccines available in the market like Pfizer, Moderna, AstraZeneca, Johnson and Johnson, and Sinovac. This research aimed to analyze the preference on the existing vaccine attributes of COVID-19.

Study design

Specifically, this study considered 7 attributes such as cost, brand, recommendations, efficacy, side effects, vaccine type, and dose.

Methods

A conjoint analysis with orthogonal design was utilized and 865 respondents were participated.

Results

The result showed that consumers considered brand as the highest attribute, specifically Pfizer and Moderna among other brands. Moreover, the efficacy of 90% and higher were the preferred vaccine with 1 in 100 patient side effects reported. It was seen that safety and effectiveness is the priority in choosing a COVID-19 vaccine. Interestingly, the knowledge and understanding of the COVID-19 vaccine was found to drive consumer's preference for the vaccines available.

Conclusions

The findings of this study could be utilized by the government to increase the willingness to be vaccinated. Lastly, the result of this study would pave a way to promote herd immunity to help fight the COVID-19 pandemic worldwide.

Epidemiological risk factors associated with primary infection by Epstein-Barr virus in HIV-1-positive subjects in the Brazilian Amazon region

To identify the prevalence and risk factors for primary Epstein–Barr virus (EBV) infection in human immunodeficiency virus (HIV)-1-positive adult treatment-naïve patients between January 2018 and December 2019 in a state of the Brazilian Amazon region. A total of 268 HIV-1 positive patients and 65 blood donors participated in the study. Epidemiological data were obtained from medical records and through a designed questionnaire. EBV infection was screened by the semiquantitative detection of anti-viral capsid antigen (VCA) EBV IgM and IgG, followed by molecular detection of the EBNA-3C gene. The plasma viral loads of HIV-1 and EBV were quantified using a commercial kit. The prevalence of primary coinfection was 7.12%. The associated risk factors were education level, family income, history of illicit drug use and sexually transmitted infections, homosexual contact and condom nonuse. Approximately 58.5% had late initiation of highly active antiretroviral therapy, which influenced the risk of HIV-EBV 1/2 multiple infection (odds ratio (OR): 4.76; 95% CI 1.51–15.04) and symptom development (p = 0.004). HIV viral load was associated with patient age (OR: 2.04; 95% CI 2.01–2.07; p = 0.026) and duration of illicit drug use (OR: 1.57; 95% CI 1.12–2.22; p = 0.0548). EBV viral load was associated with younger age (OR: 0.82; 95% CI 0.79–1.03; p = 0.0579). The replication of both viruses was associated with symptom development (HIV = OR: 2.06; 95% CI 1.22–3.50; p = 0.0073; EBV = OR: 8.81; 95% CI 1–10; p = 0.0447). The prevalence of HIV/EBV coinfection was lower than that observed in other studies, and social vulnerability and promiscuous sexual behavior were associated risk factors. A long time of HIV-1 infection, without therapy, influenced the risk of coinfection and disease progression. The viral loads of both viruses may be associated with some epidemiological aspects of the population.

Who Aren't We Reaching? Young Sexual Minority Men's Non-participation in an HIV-Prevention and Mental Health Clinical Trial

Despite many successful clinical trials to test HIV-prevention interventions for sexual minority men (SMM), not all SMM are reached by these trials. Identifying factors associated with non-participation in these trials could help to ensure the benefits of research extend to all SMM. Prospective participants in New York City and Miami were screened to determine eligibility for a baseline assessment for a mental health/HIV-prevention trial (N = 633 eligible on screen). Logistic regression and classification and regression tree (CART) analysis identified predictors of non-participation in the baseline, among those who were screened as eligible and invited to participate. Individuals who reported unknown HIV status were more likely to be non-participators than those who reported being HIV-negative (OR = 2.39; 95% CI 1.41, 4.04). In New York City, Latinx SMM were more likely to be non-participators than non-Latinx white SMM (OR = 1.81; 95% CI, 1.09, 2.98). A CART model pruned two predictors of non-participation: knowledge of HIV status and age, such that SMM with unknown HIV status and SMM ages 18-19 were less likely to participate. Young SMM who did not know their HIV status, and thus are more likely to acquire and transmit HIV, were less likely to participate. Additionally, younger SMM (18-19 years) and Latinx SMM in New York City were less likely to participate. The findings suggest the importance of tailored recruitment to ensure HIV-prevention/mental health trials reach all SMM.

COVID-19 Vaccine Acceptance among an Online Sample of Sexual and Gender Minority Men and Transgender Women

Sexual and gender minority (SGM) populations are particularly vulnerable to poor COVID-19 outcomes and are more likely to experience stigma and medical mistrust that may impact COVID-19 vaccine acceptance. This study examined the prevalence of COVID testing and diagnosis and assessed COVID-19 vaccine acceptance among a large sample of SGM. Participants were recruited as part of an online cross-sectional study focused on an HIV biomedical prevention technology willingness in the United States at increased risk for HIV sero-conversion. Multivariate linear analysis was conducted to examine COVID-19 vaccine acceptance. The study sample included 1350 predominately gay (61.6%), Black (57.9%), cis-gender (95.7%) males with a mean age of 32.9 years. Medical mistrust and social concern regarding COVID-19 vaccine stigma were significantly associated with decreased COVID-19 vaccine acceptance, and altruism was significantly associated with increased vaccine acceptance. Black participants were significantly less likely to accept a COVID-19 vaccine, and Asian participants were significantly more likely to accept a vaccine, compared to White peers. As the planning of COVID-19 vaccine rollout efforts is conceptualized and designed, these data may inform equitable implementation strategies and prevent worsening health inequities among SGM populations.