Abstract
BackgroundMore and more HIV therapeutic vaccines will enter clinical trials; however, little is known about the willingness to participate (WTP) in HIV therapeutic vaccine trials among HIV-positive individuals.ObjectiveTo investigate the WTP in HIV therapeutic vaccine trials among Chinese HIV-infected patients.MethodsWe conducted a cross-sectional survey on HIV-positive inpatients and outpatients at Shanghai Public Health Center. A total of 447 participants were recruited into this study. Following an introduction with general information on HIV therapeutic vaccine and its potential effectiveness and side effects, each participant completed a questionnaire in a self-administered form. The questionnaires covered demographics, high-risk behaviors, clinical characteristics and willingness to participate in HIV therapeutic vaccine trial.ResultsThe overall willingness to participate in HIV therapeutic vaccine trials was 91.5%. Interestingly, multivariate logistic regression analyses demonstrated that the willingness was higher for those sexually infected by HIV (odds ratio [OR]: 4.36; 95% confidence interval [CI]: 1.53–12.41), diagnosed as HIV-1 infection for greater than 5 years (OR: 7.12, 95% CI: 1.83–27.76), and with the presence of infectious complications (OR: 2.75; 95% CI: 1.02–7.45). The primary reason for participation was to delay or reduce antiretroviral treatment (ART) and to avoid ART side effects (76.6%), and then followed by delaying disease progression (74.9%), increasing immune response to suppress opportunistic infections (57.7%) and preventing the development of drug resistance (37.1%). Reasons for unwillingness to participate mainly included concern for safety (37.0%), lack of knowledge on therapeutic vaccine (33.3%), and satisfaction with ART effectiveness (22.2%).ConclusionsThe WTP in HIV therapeutic vaccine trials was high among HIV-infected Chinese patients. HIV+ subjects who acquired infection through sexual contact and who were diagnosed for more than 5 years may represent a good candidate population for enrollment in therapeutic vaccine trials.
Highlights
According to the UNAIDS Global Report 2013, an estimated 35.3 million people are living with HIV worldwide, with 2.3 million of those people newly infected in 2013 [1]
willingness to participate (WTP) was positively associated with a history of sex with a drug-using partner, needle and syringe sharing with a new drug use partner in the past 3 months, perceived family support for participation, and perceived vaccine protection against HIV infection; alternatively, WTP was negatively associated with the perceived risk of social stigma and isolation for participation [19]
In Beijing, WTP of MSM was 70.9% (35.8% definitely willing and 35.1% most likely willing), and the analysis suggested that perceived family support, perceived protection against HIV infection and fear that participation would result in social distancing were associated with WTP [18]
Summary
According to the UNAIDS Global Report 2013, an estimated 35.3 million people are living with HIV worldwide, with 2.3 million of those people newly infected in 2013 [1]. The strategies for controlling the global HIV epidemic include escalating the usage of condoms, developing vaccine and vaginal/ rectal microbicides and implementing treatment as prevention [2,3]. As an effective vaccine remains as the most cost-effective approach and less depends on human behavior for success [2], the development of an effective and safe vaccine for prevention of AIDS remains as a global public health priority and the greatest opportunity to eventually end the AIDS pandemic [2,4,5]. More and more HIV therapeutic vaccines will enter clinical trials; little is known about the willingness to participate (WTP) in HIV therapeutic vaccine trials among HIV-positive individuals
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