Abstract
BackgroundThe HIV epidemic among men who have sex with men (MSM) continues to expand globally. The addition of an efficacious, prophylactic vaccine to combination prevention offers immense hope, particularly in low- and middle- income countries which bear the greatest global impact. However, in these settings, there is a paucity of vaccine preparedness studies that specifically pertain to MSM. Our study is the first vaccine preparedness study among MSM and female sex workers (FSWs) in Kenya. In this paper, we explore willingness of Kenyan MSM to participate in HIV vaccine efficacy trials. In addition to individual and socio-cultural motivators and barriers that influence willingness to participate (WTP), we explore the associations or linkages that participants draw between their experiences with or knowledge of medical research both generally and within the context of HIV/AIDS, their perceptions of a future HIV vaccine and their willingness to participate in HIV vaccine trials.MethodsUsing a social network-based approach, we employed snowball sampling to recruit MSM into the study from Kisumu, Mombasa, and Nairobi. A field team consisting of seven community researchers conducted in-depth interviews with a total of 70 study participants. A coding scheme for transcribed and translated data was developed and the data was then analysed thematically.ResultsMost participants felt that an HIV vaccine would bring a number of benefits to self, as well as to MSM communities, including quelling personal fears related to HIV acquisition and reducing/eliminating stigma and discrimination shouldered by their community. Willingness to participate in HIV vaccine efficacy trials was highly motivated by various forms of altruism. Specific researcher responsibilities centred on safe-guarding the rights and well-being of participants were also found to govern WTP, as were reflections on the acceptability of a future preventive HIV vaccine.ConclusionStrategies for engagement of communities and recruitment of trial volunteers for HIV vaccine efficacy trials should not only be grounded in and informed by investigations into individual and socio-cultural factors that impact WTP, but also by explorations of participants’ existing experiences with or knowledge of medical research as well as attitudes and acceptance towards a future HIV vaccine.
Highlights
The Human immunodeficiency virus (HIV) epidemic among men who have sex with men (MSM) continues to expand globally
As the newest promising HIV vaccine moves into the human testing stage [16] and with nearly three dozen other vaccines in some stage of human trials, there is a continual need for volunteer communities, that is groups of individuals who identify with specific communities (e.g., MSM, FSWs – female sex workers) and consent to participation in clinical trials, to test vaccine efficacy
We explore the associations or linkages that participants draw between their experiences with or knowledge of medical research both generally and within the context of HIV/Acquired immune deficiency syndrome (AIDS), their perceptions of a future HIV vaccine and their willingness to participate in HIV vaccine trials
Summary
The HIV epidemic among men who have sex with men (MSM) continues to expand globally. The addition of an efficacious, prophylactic vaccine to combination prevention offers immense hope, in low- and middle- income countries which bear the greatest global impact. In the fight against one of the most intractable human epidemics, there are various technologies and techniques available to public health scientists which can be classified as behavioural [1, 2], structural [3, 4] and biomedical interventions [5, 6], with PrEP (pre-exposure prophylaxis) being the most recent addition to combination prevention Despite these developments, HIV infection rates remain high in low- and middle- income countries with men who have sex with men (MSM) disproportionately affected compared to other groups at greater risk for HIV infection [7,8,9]. The resulting unequal power relations between partners from the global north (donors/researchers) and those from the global south (recipients/participants) have come to characterise the contemporary landscape of medical research in Kenya
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