title: Negative social impacts among volunteers in an HIV vaccine efficacy trial.
abstract: OBJECTIVE
  Describe the negative social impacts (NSIs) and their predictors in an HIV vaccine efficacy trial.
  
  
  METHODS
  Volunteers in the North American phase 3 trial of AIDSVAX B/B vaccine were questioned semiannually about NSIs. Multivariable logistic models identified independent predictors of NSI reporting.
  
  
  RESULTS
  Of 5417 volunteers (94% male), 18% reported at least 1 NSI. Most events occurred early during trial participation and involved concerns by family and friends that the volunteer was HIV-infected or at risk for infection. Problems with disability/life insurance and employment occurred less frequently (<1%). Individuals who became HIV-infected reported NSIs similar to HIV-negative volunteers. In multipredictor analysis of male volunteers, NSI reporters were younger (adjusted odds ratio [OR(Adj)] = 1.6, 95% confidence interval [CI]: 1.2 to 2.1 and OR(Adj) = 1.4, 95% CI: 1.1 to 1.8 for ages 18 to 25 years and 26 to 35 years vs. > or =46 years, respectively), enrolled at sites with 50 or fewer volunteers (OR(Adj) = 2.3, 95% CI: 1.7 to 3.1), or lived in cities with high AIDS case rates (OR(Adj) = 1.4, 95% CI: 1.1 to 1.8).
  
  
  CONCLUSIONS
  A modest proportion of vaccine efficacy trial volunteers reported problems in interpersonal relationships from trial participation. Serious harms involving insurance and employment were rare. Strategies to prevent harm from disclosure, particularly for younger volunteers and those from high seroincidence sites, may reduce NSIs in future trials.
authors.affiliation: AIDS Office, San Francisco Department of Public Health, San Francisco, CA, USA. jonathan.fuchs@sfdph.org
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fuchs
authors.forename: Marcus
authors.initials: M
authors.lastname: Durham
authors.forename: Eleanor
authors.initials: E
authors.lastname: McLellan-Lemal
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Grant
authors.initials: G
authors.lastname: Colfax
authors.forename: Marc
authors.initials: M
authors.lastname: Gurwith
authors.forename: Susan
authors.initials: S
authors.lastname: Buchbinder
mesh_terms: D016915:AIDS Vaccines; D000328:Adult; D005190:Family; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000517:prevention & control / Q000523:psychology*; D006801:Humans; D008297:Male; D012309:Risk-Taking; D012922:Social Change; D012940:Social Problems; D016896:Treatment Outcome; D014838:Volunteers / Q000523:psychology*
chemical_list: D016915:AIDS Vaccines