title: Pediatric HIV type 1 vaccine trial acceptability among mothers in Kenya.
abstract: Vaccination of infants against human immunodeficiency virus type 1 (HIV-1) may prevent mother-to-child HIV-1 transmission. Successful trials and immunization efforts will depend on the willingness of individuals to participate in pediatric vaccine research and acceptance of infant HIV-1 vaccines. In a cross-sectional study, pregnant women presenting to a Nairobi antenatal clinic for routine care were interviewed regarding their attitudes toward participation in research studies and HIV-1 vaccine acceptability for their infants. Among 805 women, 782 (97%) reported they would vaccinate their infant against HIV-1 and 729 (91%) reported willingness to enroll their infant in a research study. However, only 644 (80%) would enroll their infants if HIV- 1 testing was required every 3 months and 513 (64%) would agree to HIV-1 vaccine trial participation. Reasons for not wanting to enroll in a pediatric HIV-1 vaccine trial included concerns about side effects (75%), partner objection (34%), and fear of discrimination (10%), HIV-1 acquisition (8%), or false-positive HIV-1 results (5%). The strongest correlate of pediatric vaccine trial participation was maternal willingness to be a vaccine trial participant herself; in univariate and multivariate models this was associated with a 17-fold increased likelihood of participation (HR 17.1; 95% CI 11.7-25; p < 0.001). We conclude from these results that immunizing infants against HIV-1 and participation in pediatric vaccine trials are generally acceptable to women at high risk for HIV-1 infection. It will be important to address barriers identified in this study and to include male partners when mobilizing communities for pediatric HIV-1 vaccine trials and immunization programs.
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington 98104, USA. cfarq@u.washington.edu
authors.forename: Carey
authors.initials: C
authors.lastname: Farquhar
authors.forename: Grace C
authors.initials: GC
authors.lastname: John-Stewart
authors.forename: Francis N
authors.initials: FN
authors.lastname: John
authors.forename: Marjory N
authors.initials: MN
authors.lastname: Kabura
authors.forename: James N
authors.initials: JN
authors.lastname: Kiarie
mesh_terms: D016915:AIDS Vaccines / Q000008:administration & dosage*; D000328:Adult; D002648:Child; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D015497:HIV-1 / Q000276:immunology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007630:Kenya; D008297:Male; D009035:Mothers; D010342:Patient Acceptance of Health Care; D010372:Pediatrics; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D045808:Refusal to Participate; D014611:Vaccination
chemical_list: D016915:AIDS Vaccines