Using hepatitis A and B vaccination as a paradigm for effective HIV vaccine delivery.
BACKGROUND
An understanding of vaccine acceptance and uptake is imperative for successful vaccination of populations that will be primary targets for vaccination after a vaccine against HIV is developed and ready for dissemination. Experiences with vaccination against vaccine-preventable hepatitis (VPH) among men who have sex with men (MSM) may offer key insights to inform future HIV vaccination strategies. The purpose of this analysis was to explore what is known currently about vaccination among MSM, using knowledge gained from vaccination against VPH, and to identify important considerations from these experiences that must be explored further as a vaccine against HIV is promoted among MSM. Because cultural and political differences make it difficult to extrapolate findings from studies in one country to another, we have focused our analyses on studies conducted in the USA.


METHODS
Through a qualitative systematic review of published reports, we identified eight studies that reported correlates of VPH among MSM in the USA.


RESULTS
Six major domains of variables associated with vaccination against VPH were identified, including: demographics (e.g. younger age, higher educational attainment); increased vaccine knowledge; increased access to health care; provider recommendation; behaviours (e.g. same-sex behaviour, health-promoting and disease-preventing behaviours); and psychosocial factors (e.g. openness about one's sexual orientation, reduced barriers to being vaccinated, self-efficacy).


CONCLUSIONS
Further research is needed to understand vaccination behaviour among MSM and to maximise acceptance and uptake after a vaccine exists. Experiences with VPH provide a real-world model on which to base preliminary assumptions about acceptance and uptake of a vaccine against HIV.
Rhodes
Scott D
SD
Section on Society and Health, Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University Health Sciences, Medical Center Boulevard, Winston-Salem, NC 27157-1063, USA. srhodes@wfubmc.edu
Yee
Leland J
LJ
D016915:AIDS Vaccines / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D015658:HIV Infections / Q000517:prevention & control*; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods; D006506:Hepatitis A / Q000517:prevention & control; D022362:Hepatitis A Vaccines / Q000627:therapeutic use; D006509:Hepatitis B / Q000517:prevention & control; D017325:Hepatitis B Vaccines / Q000627:therapeutic use; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D014481:United States
D016915:AIDS Vaccines; D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines