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Choi J, May SB, Dang BN, Markham C, McGlone M, Cuccaro PM. Acceptability of a Future HIV Vaccine: A Rapid Scoping Review. J Acquir Immune Defic Syndr 2024; 96:197-207. [PMID: 38905472 DOI: 10.1097/qai.0000000000003416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/29/2024] [Indexed: 06/23/2024]
Abstract
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.
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Affiliation(s)
- Jihye Choi
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX
| | - Sarah B May
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX
| | - Bich N Dang
- Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX
- VA Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX; and
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX
| | - Matthew McGlone
- Department of Communication Studies, Moody College of Communication, The University of Texas at Austin, Austin, TX
| | - Paula M Cuccaro
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX
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Carey JW, Courtenay-Quirk C, Carnes N, Wilkes AL, Schoua-Glusberg A, Tesfaye C, Betley V, Pedersen S, Randall LA, Frew PM. HIV Testing Program Activities and Challenges in Four U.S. Urban Areas. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:99-115. [PMID: 35438537 PMCID: PMC10953676 DOI: 10.1521/aeap.2022.34.2.99] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The national "Ending the HIV Epidemic: A Plan for America" supports expanded testing in jurisdictions and groups with disproportionate HIV burden. Public health planners benefit from learning HIV testing service (HTS) strengths, challenges, and innovations. We conducted semistructured interviews with 120 HTS staff from local health departments, community-based organizations, and community members in Houston, Texas; Miami, Florida; New Orleans, Louisiana; and Washington, DC. We coded interview transcripts using qualitative methods to identify themes. Program strengths include HIV testing integration with other client services; prioritized testing and tailored incentives; multiple advertising methods; and partnerships among HTS providers. Challenges include stigma, fear, and disparities; funding requirements that create competition between providers; and service accessibility, unnecessary repeat testing, and insufficient innovation. The four jurisdictions addressed some, but not all, of these challenges. Cross-jurisdictional collaboration, together with state and federal partners plus program data may help identify additional strategies for strengthening HTS.
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Affiliation(s)
- James W Carey
- Division of HIV Prevention, at the Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cari Courtenay-Quirk
- HIV Research Branch within the Division of HIV Prevention, at the Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Neal Carnes
- HIV Prevention Capacity Development Branch within the Division of HIV Prevention, at the Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Aisha L Wilkes
- Prevention Research Branch within the Division of HIV Prevention, at the Centers for Disease Control and Prevention, Atlanta, Georgia; currently she is with the National Center for Injury Prevention and Control at CDC
| | | | - Casey Tesfaye
- Research Support Services Inc. in Evanston, Illinois
| | | | | | | | - Paula M Frew
- UNLV Population Health & Health Equity Initiative, Las Vegas, Nevada at the time of the study; currently she is with Merck & Co., Inc., Kenilworth, New Jersey
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Sharkey T, Wall KM, Parker R, Tichacek A, Pappas-DeLuca KA, Kilembe W, Inambao M, Malama K, Hoagland A, Peeling R, Allen S. A cluster randomized trial to reduce HIV risk from outside partnerships in Zambian HIV-Negative couples using a novel behavioral intervention, "Strengthening Our Vows": Study protocol and baseline data. Contemp Clin Trials Commun 2021; 24:100850. [PMID: 34622087 PMCID: PMC8481973 DOI: 10.1016/j.conctc.2021.100850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 08/02/2021] [Accepted: 09/08/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Heterosexual couples contribute to most new HIV infections in areas of generalized HIV epidemics in sub-Saharan Africa. After Couples' Voluntary HIV Counseling and Testing (CVCT), heterosexual concordant HIV negative couples (CNC) in cohabiting unions contribute to approximately 47% of residual new infections in couples. These infections are attributed to concurrent sexual partners, a key driver of the HIV epidemic in Zambia. METHODS/DESIGN Ten Zambian government clinics in two of the largest cities were randomized in matched pairs to a Strengthening Our Vows (SOV) intervention or a Good Health Package (GHP) comparison arm. SOV addressed preventing HIV infection from concurrent partners and protecting spouses after exposures outside the relationship. GHP focused on handwashing; water chlorination; household deworming; and screening for hypertension, diabetes and schistosomiasis. CNC were referred from CVCT services in government clinics. Follow-up includes post-intervention questionnaires and outcome assessments through 60 months. Longitudinal outcomes of interest include self-report and laboratory markers of condomless sex with outside partners and reported sexual agreements. We present baseline characteristics and factors associated with study arm and reported risk using descriptive statistics. RESULTS The mean age of men was 32 and 26 for women. On average, couples cohabited for 6 years and had 2 children. Baseline analyses demonstrated some failures of randomization by study arm which will be considered in future primary analyses of longitudinal data. An HIV/STI risk factor composite was not different in the two study arms. Almost one-quarter of couples had an HIV risk factor at baseline. DISCUSSION In preparation for future biomedical and behavioral interventions in sub-Saharan Africa, it is critical to understand and decrease HIV risk within CNC.
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Affiliation(s)
- Tyronza Sharkey
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, 30322, USA
- London School of Hygiene and Tropical Medicine, UK
| | - Kristin M. Wall
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, 30322, USA
- Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, 30322, USA
| | - Rachel Parker
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, 30322, USA
| | - Amanda Tichacek
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, 30322, USA
| | - Katina A. Pappas-DeLuca
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, 30322, USA
| | - William Kilembe
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, 30322, USA
| | - Mubiana Inambao
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, 30322, USA
| | - Kalonde Malama
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, 30322, USA
| | - Alexandra Hoagland
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, 30322, USA
| | | | - Susan Allen
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Laney Graduate School, Emory University, Atlanta, GA, 30322, USA
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McMahon JM, Simmons J, Haberer JE, Mannheimer S, Leblanc NM, Torres L, Quiles R, Aedo G, Javier A, Braksmajer A, Harriman G, Trabold N, Pouget ER, Kurth A, Smith MDR, Brasch J, Podsiadly EJ, Anderson PL. The Magnetic Couples Study: protocol for a mixed methods prospective cohort study of HIV-serodifferent heterosexual couples' perspectives and use of pre-exposure prophylaxis (PrEP). BMJ Open 2021; 11:e048993. [PMID: 34210734 PMCID: PMC8252879 DOI: 10.1136/bmjopen-2021-048993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION HIV transmission within serodifferent heterosexual couples plays a key role in sustaining the global HIV pandemic. In the USA, transmission within established mixed-status couples accounts for up to half of all new HIV infections among heterosexuals. Oral HIV pre-exposure prophylaxis (PrEP) is a highly effective prevention method, although underutilised among serodifferent couples. Moreover, there is a dearth of research on US HIV-serodifferent couples' perspectives and use of PrEP, alone or in combination with other prevention methods. In this paper, we describe the study protocol for the Magnetic Couples Study, designed to fill critical knowledge gaps regarding HIV-serodifferent heterosexual couples' perspectives, experiences and utilisation of PrEP. METHODS AND ANALYSIS The Magnetic Couples Study is a mixed methods prospective cohort study designed to describe temporal patterns and identify determinants at multiple levels (individual, couple, HCF) of PrEP outcomes along the care continuum (PrEP awareness, linkage, uptake, retention and medication adherence) among HIV-serodifferent heterosexual couples residing in New York City. The study will also examine clinical management of PrEP, side effects and changes in sexual-related and substance use-related behaviour. A prospective cohort of 230 mixed-status couples already on oral PrEP was recruited, with quarterly assessments over 18 months; in addition, a cross-sectional sample of 150 mixed-status couples not currently on PrEP was recruited. In-depth semistructured qualitative interviews were conducted with a subsample of 25 couples. Actor-partner interdependence modelling using multilevel analysis will be employed for the analysis of longitudinal dyadic data. Framework analysis will be used to analyse qualitative data. A parallel convergent design will be used for mixed methods integration. ETHICS AND DISSEMINATION The study was approved by the University of Rochester Institutional Review Board (RSRB00052766). Study findings will be disseminated to community members and providers and to researchers and policy makers.
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Affiliation(s)
- James M McMahon
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | - Janie Simmons
- School of Global Public Health, New York University, New York, New York, USA
| | - Jessica E Haberer
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Sharon Mannheimer
- Department of Medicine, New York City Health + Hospitals Harlem, New York, New York, USA
- Department of Medicine, Columbia University Medical Center, New York, New York, USA
| | - Natalie M Leblanc
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | - Leilani Torres
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | - Robert Quiles
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | - Guillermo Aedo
- School of Global Public Health, New York University, New York, New York, USA
| | - Anabel Javier
- School of Global Public Health, New York University, New York, New York, USA
| | - Amy Braksmajer
- Department of Sociology, State University of New York at Geneseo, Geneseo, New York, USA
| | - Graham Harriman
- HIV Health and Human Services Planning Council, New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - Nicole Trabold
- College of Health Science and Technology, Rochester Institute of Technology, Rochester, New York, USA
| | - Enrique R Pouget
- Department of Health and Nutrition Sciences, Brooklyn College, The City University of New York, Brooklyn, New York, USA
| | - Ann Kurth
- School of Nursing, Yale University, Orange, Connecticut, USA
| | - Martez D R Smith
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | - Judith Brasch
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | - Eric J Podsiadly
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | - Peter L Anderson
- School of Pharmacy and Pharmaceutical Sciences, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA
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