Abstract
An HIV vaccine, once it becomes available, could reduce vulnerability to HIV among African-American women. The purpose of this study was to assess determinants of HIV vaccine acceptability among African-American women across hypothetical levels of vaccine efficacy. Participants were recruited from a hospital-based family planning clinic in Atlanta, GA serving low-income patients (N = 321). Data were collected from audio-computer assisted surveys administered in the clinic waiting room. Psychosocial survey items were guided by Risk Homeostasis Theory (RHT) and Social Cognitive Theory (SCT). Multivariate logistic regression was used to identify determinants of acceptability for two hypothetical HIV vaccines with 50% and 90% efficacy. Overall, 63% of participants would accept a vaccine with 50% efficacy and 85% would accept a vaccine with 90% efficacy. In multivariate analyses, odds of acceptability for a vaccine with 50% efficacy were higher among participants with greater perceived HIV vaccine benefits (AOR = 1.13, p < 0.001) and lower among participants with more than high school education (AOR = 0.47, p = 0.033) and greater perceived costs of HIV vaccination (AOR = 0.95, p = 0.010). Odds of acceptability for a vaccine with 90% efficacy were higher among participants with greater perceived costs of unprotected sex (AOR = 1.08, p = 0.026), HIV vaccine benefits (AOR = 1.23, p < 0.001) and self-efficacy for sex refusal (AOR = 1.11, p = 0.044). HIV vaccine acceptability was high, particularly for a vaccine with 90% efficacy. Findings suggest that demographic and psychosocial factors may impact acceptability of an eventual HIV vaccine. Once an HIV vaccine is available, interventions to maximize uptake may benefit from using RHT and SCT constructs to target relevant psychosocial factors, such as perceived benefits and perceived costs of vaccination.
Highlights
African-American women are disproportionately affected by HIV [1,2,3]
African-American women are disproportionately affected by STIs such as gonorrhea, chlamydia, trichomoniasis, and genital herpes (HSV-2), which can increase the risk of contracting HIV and transmitting HIV to others [6,7,8,9]
The first aim of this study was to assess anticipated HIV vaccine acceptability depending on varying HIV vaccine characteristics
Summary
African-American women are disproportionately affected by HIV [1,2,3]. In 2009, an estimated11,200 women were diagnosed with HIV in the U.S [4], and the rate of new HIV infections amongAfrican-American women was 15 times the rate among White women [4,5]. African-American women are disproportionately affected by HIV [1,2,3]. African-American women are disproportionately affected by STIs such as gonorrhea, chlamydia, trichomoniasis, and genital herpes (HSV-2), which can increase the risk of contracting HIV and transmitting HIV to others [6,7,8,9]. The introduction of a safe and effective HIV vaccine provides our best hope for ending the HIV pandemic [11], and would provide women, African-American women, with much needed volitional control over vulnerability to HIV [12]. Health history included: previous STD diagnosis, previous HIV test, and a brief mental health assessment (5 item Likert scale, higher scores indicate better mental health, alpha = 0.77) [26].
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