"PROUD to have been involved": an evaluation of participant and community involvement in the PROUD HIV prevention trial

Barriers and facilitators to HIV pre-exposure prophylaxis for cisgender and transgender women in the UK

Uptake of oral HIV pre-exposure prophylaxis (PrEP) among cisgender and transgender women in the UK has been low. In this Review, we explore the barriers and facilitators to PrEP access for these groups, with a focus on health equity. We included 20 studies, including seven abstracts presented at conferences. The study samples were disparate, with minimal overlap between papers. We identified barriers at the individual, interpersonal, and structural levels, including poor awareness and acceptability; stigma, race, and ethnicity; restricted access to PrEP; and exclusion from clinical trials. We found hidden subpopulations of women who could potentially benefit from PrEP, of whom little is known about their PrEP knowledge, preferences, and access due to a lack of UK research. These subpopulations include non-Black African women, transgender women, sex workers, migrant women, women experiencing intimate partner violence, incarcerated women, and women who inject drugs. We highlight opportunities to address these obstacles. Research on the use of PrEP by women in the UK is scarce, and existing research has poor granularity. Without a better understanding of the needs and preferences of the full spectrum of women who could benefit from PrEP, the UK will not reach zero transmissions by 2030.

Patient and public involvement in mobile health-based research for hay fever: a qualitative study of patient and public involvement implementation process

BACKGROUND

Smartphones are being increasingly used for research owing to their multifunctionality and flexibility, and crowdsourced research using smartphone applications (apps) is effective in the early detection and management of chronic diseases. We developed the AllerSearch app to gather real-world data on individual subjective symptoms and lifestyle factors related to hay fever. This study established a foundation for interactive research by adopting novel, diverse perspectives accrued through implementing the principles of patient and public involvement (PPI) in the development of our app.

METHODS

Patients and members of the public with a history or family history of hay fever were recruited from November 2019 to December 2021 through a dedicated website, social networking services, and web briefing according to the PPI Guidebook 2019 by the Japan Agency for Medical Research and Development. Nine opinion exchange meetings were held from February 2020 to December 2021 to collect opinions and suggestions for updating the app. After each meeting, interactive evaluations from PPI contributors and researchers were collected. The compiled suggestions were then incorporated into the app, establishing an active feedback loop fed by the consistently interactive infrastructure.

RESULTS

Four PPI contributors (one man and three women) were recruited, and 93 items were added/changed in the in-app survey questionnaire in accordance with discussions from the exchange meetings. The exchange meetings emphasized an atmosphere and opportunity for participants to speak up, ensuring frequent opportunities for them to contribute to the research. In March 2020, a public website was created to display real-time outcomes of the number of participants and users' hay-fever-preventative behaviors. In August 2020, a new PPI-implemented AllerSearch app was released.

CONCLUSIONS

This study marks the first research on clinical smartphone apps for hay fever in Japan that implements PPI throughout its timeline from research and development to the publication of research results. Taking advantage of the distinct perspectives offered by PPI contributors, a step was taken toward actualizing a foundation for an interactive research environment. These results should promote future PPI research and foster the establishment of a social construct that enables PPI efforts in various fields.

Brief Report: Representations and Willingness of People Living With HIV in Switzerland to Participate in HIV Cure Trials: The Case of Gene-Modified Cell Therapies

BACKGROUND

Recent advances made in cell and gene therapies for cancer suggest that they represent plausible strategies to cure HIV. However, the health risks and constraints associated with these therapies require a deeper understanding of the expectations of such treatments among people living with HIV (PLWH).

METHODS

We conducted 15 semistructured in-depth interviews among patients from 2 HIV units in Switzerland. After a conversation about their perceptions of research on HIV therapies, participants were provided with a trial description using a gene-modified cell therapy as a potentially curative approach. They were invited to discuss how they might consider participation in the trial. Content analysis was performed to identify core themes.

RESULTS

Participants perceived the trial as burdensome and uncertain. Most were aware that cure was not guaranteed, and 6 of the 15 considered that they would participate. Two main concerns were expressed about potential participation: (1) the impact on the professional life and fear to be stigmatized because of this and (2) the fact that stopping antiretroviral treatment would challenge the balance currently achieved in their lives. The decision to participate would depend on their understanding of the trial, the availability of sufficient information, and the relationship with health care professionals.

CONCLUSION

Involving PLWH in early stages of research would be crucial to improve their understanding of gene-modified cell therapies. It could also help adapt trials to address key factors, including the anticipation of stigma, which may discourage PLWH from participating in treatment research.

Learning about how public involvement strengthens HIV research as a medical student

PLAIN ENGLISH SUMMARY

A small medical school research project entitled 'PPI to strengthen clinical and population health research' caused me to look at an entirely new field - that of Public and Patient Involvement (PPI). PPI is the development of an active partnership between patients and the public and researchers to work alongside each other not just during trial participation but, at each research step. Internet research and use of materials supplied by my tutors changed my understanding and appreciation for the field of PPI. Coming across the story surrounding gay rights campaigners and development of early PPI inspired me to investigate how it is used it modern studies. It struck me how despite its importance, PPI often went undiscussed in contemporary studies. However, one study named PROUD used and reported PPI in an exemplary fashion in order to combat issues and strengthen the trial. PROUD's PPI improved study design, safety and advertising as well as providing reassurance in difficult times. It also improved recruitment, dissemination of information and made sure that results and future research fields were relevant. Through PROUD and also my own experiences working with a PPI group I was able to develop an understanding and appreciation for the importance PPI. I write with hope to make my learning available to others.

ABSTRACT

A research project during my third year at medical school introduced me to PPI. PPI is defined as research carried out with or by members of the public rather than to, about or for them. Historical gay rights activists' involvement in research catalysed developments in PPI before it was widely recognised. A contemporary study, PROUD, used exemplary PPI contributions to tackle these issues and make the study successful. My research project was entitled 'How did PPI contribute towards the PROUD study & what can be learnt from this?'. This letter aims to answer this question but also include my personal reflections on my work and how I developed an understanding and appreciation for the importance PPI. PubMed and Google were examined, as well as University resources. Correspondence with PROUDs lead investigator also informed this letter. It was found that PROUD's PPI improved study design, safety and advertising as well as providing reassurance in difficult times. It also improved recruitment, dissemination of information and made sure that results and future research fields were relevant. This allows us to understand and appreciate PPI's role in research and the provision of healthcare. It is also important to increase discussion and learning around PPI for the future.