Abstract
We conducted Community-Based Participatory Research (CBPR), using a qualitative focus group design, to assess factors that might impact participation of high-risk impoverished adults in future HIV Vaccine Trials (HIVVTs). The participants were 40 homeless and low-income adults recruited from subsidized apartments and homeless shelters in Los Angeles. Findings revealed that the participants expressed both concerns and interest in future HIVVTs. Concerns centered on the impact of the vaccine on their physical health, the possibility of seroconverting and its associated stigma. While distrust of the government was pervasive, the participants were interested in receiving more information about the vaccine from the researchers. They also wished to have their voices heard by the researchers early in the design of the vaccines. Motivating factors were also discovered, and included altruism, compensation and access to care. Perception that risk behaviors might increase among some as a result of participation in a future HIVVT was likewise revealed. Implications of the study reveal that while impoverished populations are interested in participating in future HIVVTs, the researchers must address concerns early on. Moreover, the importance of ongoing education and counseling to warn about hazards of engaging in risky behavior while participating in a future HIVVT was critical.
Highlights
Since the Human Immunodeficiency Virus (HIV) was identified over 20 years ago, more than 19 million people have died and over 53 million people have been infected
Little is known of the challenges that will confront researchers interested in assessing the efficacy of the dozen or more Phase II and Phase III clinical vaccine trials needed for impoverished seronegative populations who engage in high risk activities such as injection drug use (IDU), unprotected sexual activity with multiple partners, and who report recent sexually transmitted diseases (STD)
Rates of drug use and abuse range from two to ten times higher among homeless and low income populations than those in the general US population (Robertson, 1997), with over 20% of low income and sheltered homeless populations reporting injection drug use in the last 6 months (LACHD, 2002)
Summary
Since the Human Immunodeficiency Virus (HIV) was identified over 20 years ago, more than 19 million people have died and over 53 million people have been infected. Successfully tested behavioral interventions alone are not expected to stem the tide of HIV (Centers for Disease Control and Prevention [CDC] 2001). While the recent VaxGen investigation in Los Angeles (LA) has revealed overall non-significant findings, the question arose as to whether a protective capability of the vaccine was manifested among minority populations (Kahn, 2003). As the study had been conducted primarily among white gay, and non-drug using males (Brown, 2001), this finding could not be confirmed. Little is known of the challenges that will confront researchers interested in assessing the efficacy of the dozen or more Phase II and Phase III clinical vaccine trials needed for impoverished seronegative populations who engage in high risk activities such as injection drug use (IDU), unprotected sexual activity with multiple partners, and who report recent sexually transmitted diseases (STD)
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