title: "Speaking the dialect": understanding public discourse in the aftermath of an HIV vaccine trial shutdown.
abstract: OBJECTIVE
  We investigated how persons from key populations at higher risk of HIV exposure interpreted the process and outcomes of the Step Study HIV-1 vaccine trial, which was terminated early, and implications for willingness to participate in and community support for HIV vaccine research.
  
  
  METHODS
  We used qualitative methods and a community-based approach in 9 focus groups (n = 72) among ethnically and sexually diverse populations and 6 semistructured key informant interviews in Ontario, Canada, in 2007 to 2008.
  
  
  RESULTS
  Participants construed social meaning from complex clinical and biomedical phenomena. Social representations and mental models emerged in fears of vaccine-induced infection, conceptualizations of unfair recruitment practices and increased risk behaviors among trial participants, and questioning of informed consent. Narratives of altruism and the common good demonstrated support for future trials.
  
  
  CONCLUSIONS
  Public discourse on HIV vaccine trials is a productive means of interpreting complex clinical trial processes and outcomes in the context of existing beliefs and experiences regarding HIV vaccines, medical research, and historical disenfranchisement. Strategic engagement with social representations and mental models may promote meaningful community involvement in biomedical HIV prevention research.
authors.affiliation: Factor-Inwentash Faculty of Social Work, University of Toronto, ON, Canada. p.newman@utoronto.ca
authors.forename: Peter A
authors.initials: PA
authors.lastname: Newman
authors.forename: Carmen
authors.initials: C
authors.lastname: Logie
authors.forename: Llana
authors.initials: L
authors.lastname: James
authors.forename: Tamicka
authors.initials: T
authors.lastname: Charles
authors.forename: John
authors.initials: J
authors.lastname: Maxwell
authors.forename: Khaled
authors.initials: K
authors.lastname: Salam
authors.forename: Michael
authors.initials: M
authors.lastname: Woodford
mesh_terms: D016915:AIDS Vaccines; D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D055812:Community-Based Participatory Research / Q000379:methods*; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012107:Research Design; D012309:Risk-Taking; D012737:Sex Factors; D011477:Sex Work / Q000523:psychology / Q000706:statistics & numerical data; D019529:Sexuality / Q000523:psychology / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000523:psychology; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D016915:AIDS Vaccines