title: Enhanced retention strategies and willingness to participate among hard-to-reach female sex workers in Barcelona for HIV prevention and vaccine trials.
abstract: The potential for implementation of HIV vaccine trials in hard-to-reach female sex workers in an inner city area of Barcelona, Spain was assessed via a study of HIV risk, willingness to participate and the success of retention strategies. In 130 women, serological HIV status, behavioral risk exposures and willingness to participate in future HIV vaccine trials were recorded every six months using a confidential questionnaire. An enhanced retention (ER) strategy was compared with a control retention (CR) strategy comprising the recording of data on appointment cards. HIV seroincidence and retention rates were estimated. Retention rates after 6 and 12 mo of follow-up in the ER group were 76% and 69% respectively compared with 16% and 13% in the CR group. Among the ER group 97% were willing to participate in HIV vaccine trials at baseline and, after 12 mo of follow-up. Willingness was significantly associated with higher HIV risk exposure, and higher education level. Successfully retaining these cohorts over time in settings with a high HIV seroincidence rate is an ongoing challenge that will need to be addressed to ensure participation in future trials. Furthermore, as we have demonstrated, the fact that retaining hard-to-reach populations is difficult should not exclude this target population for HIV vaccine and prevention trials.
authors.affiliation: AIDS Research Unit; Hospital Clínic/IDIBAPS-HIVACAT; University of Barcelona; Barcelona, Spain.
authors.forename: M Florencia
authors.initials: MF
authors.lastname: Etcheverry
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Evans
authors.forename: Emilia
authors.initials: E
authors.lastname: Sanchez
authors.forename: Eva
authors.initials: E
authors.lastname: Mendez-Arancibia
authors.forename: Mercé
authors.initials: M
authors.lastname: Meroño
authors.forename: José M
authors.initials: JM
authors.lastname: Gatell
authors.forename: Kimberly
authors.initials: K
authors.lastname: Page
authors.forename: Joan
authors.initials: J
authors.lastname: Joseph
mesh_terms: D016915:AIDS Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D002986:Clinical Trials as Topic; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D060386:Sex Workers; D013030:Spain; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D016915:AIDS Vaccines
keywords: HIV; HIV vaccine; female sex workers; hard-to-reach women; vaccine preparedness studies