title: Willingness to participate in HIV vaccine efficacy trials among high risk men and women from fishing communities along Lake Victoria in Uganda.
abstract: BACKGROUND
  HIV vaccine efficacy trials conducted in suitable populations are anticipated in sub-Saharan Africa. We assessed the willingness to participate in future vaccine trials among individuals from fishing communities along Lake Victoria, Uganda.
  
  
  METHODS
  From July to October 2012, we described a hypothetical vaccine trial to 328 (62.2% men) adults (18-49 years), at risk of HIV infection within 6 months of enrolment in a cohort and assessed their willingness to participate in the trial. Chi-square and logistic regression models were fitted to assess associations between vaccine trial attributes, participants' characteristics and willingness to participate.
  
  
  RESULTS
  Overall, 99.4% expressed willingness to participate in the hypothetical HIV vaccine trial. This decreased marginally with introduction of particular vaccine trial attributes. Delaying pregnancy for 10 months and large blood draw had the largest effects on reducing willingness to participate to 93.5% (p=0.02) and 94.5% (p=0.01) respectively. All the vaccine trial attributes in combination reduced willingness to participate to 90.6%. This overall reduction in willingness to participate was significantly associated with gender and exchange of gifts for sex in multivariable analysis; women were more than three times as likely to have expressed unwillingness to participate in future vaccine trials as men (aOR=3.4, 95% CI: 1.55, 7.33) and participants who never received gifts in exchange for sex were more than four times as likely to have expressed unwillingness as those who received gifts for sex (aOR=4.5; 95%CI 1.30, 16.70). The main motivators of participation were access to HIV counselling and testing services (31.9%), HIV education (18.0%), hope of being prevented from acquiring HIV (16.6%) and health care (12.5%).
  
  
  CONCLUSIONS
  Our study identifies an important population for inclusion in future HIV prevention trials and provides important insights into acceptability of trial procedures, differences in decisions of women and men and areas for further participant education.
authors.affiliation: Medical Research Council/Uganda Virus Research Institute, Uganda Research Unit on AIDS, P. O Box 49, Entebbe, Uganda. Electronic address: gershim.asiki@mrcuganda.org.
authors.forename: Gershim
authors.initials: G
authors.lastname: Asiki
authors.forename: Andrew
authors.initials: A
authors.lastname: Abaasa
authors.forename: Eugene
authors.initials: E
authors.lastname: Ruzagira
authors.forename: Freddie
authors.initials: F
authors.lastname: Kibengo
authors.forename: Ubaldo
authors.initials: U
authors.lastname: Bahemuka
authors.forename: Jerry
authors.initials: J
authors.lastname: Mulondo
authors.forename: Janet
authors.initials: J
authors.lastname: Seeley
authors.forename: Linda-Gail
authors.initials: LG
authors.lastname: Bekker
authors.forename: Sinead
authors.initials: S
authors.lastname: Delany
authors.forename: Pontiano
authors.initials: P
authors.lastname: Kaleebu
authors.forename: Anatoli
authors.initials: A
authors.lastname: Kamali
mesh_terms: D016915:AIDS Vaccines / Q000008:administration & dosage / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002986:Clinical Trials as Topic; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D016015:Logistic Models; D008297:Male; D009042:Motivation; D010358:Patient Participation / Q000706:statistics & numerical data*; D011247:Pregnancy; D012309:Risk-Taking; D012725:Sexual Behavior; D014454:Uganda; D014836:Volition; D055815:Young Adult
chemical_list: D016915:AIDS Vaccines
keywords: Fishing communities; Uganda; Vaccine trials; Willingness to participate
references.citation: AIDS Behav. 2008 Nov;12(6):842-51
references.pmid: 17668313
references.citation: AIDS. 1998 May 7;12(7):785-93
references.pmid: 9619811
references.citation: Am J Epidemiol. 2001 Apr 1;153(7):619-27
references.pmid: 11282787
references.citation: Lancet. 1985 Oct 19;2(8460):849-52
references.pmid: 2864575
references.citation: PLoS One. 2011;6(6):e20684
references.pmid: 21677779
references.citation: AIDS. 2001;15 Suppl 5:S49-57
references.pmid: 11816175
references.citation: J Infect Dis. 2003 Mar 15;187(6):879-86
references.pmid: 12660933
references.citation: AIDS Res Hum Retroviruses. 2009 Feb;25(2):217-24
references.pmid: 19239362
references.citation: AIDS. 2005 Nov 18;19(17):1939-46
references.pmid: 16260899
references.citation: J Acquir Immune Defic Syndr Hum Retrovirol. 1999 Feb 1;20(2):164-71
references.pmid: 10048904
references.citation: AIDS Res Hum Retroviruses. 2008 Nov;24(11):1445-8
references.pmid: 19000023
references.citation: J Acquir Immune Defic Syndr. 2004 Nov 1;37(3):1393-403
references.pmid: 15483469
references.citation: Trop Med Parasitol. 1995 Sep;46(3):141-6
references.pmid: 8533014
references.citation: J Acquir Immune Defic Syndr. 2011 Oct 1;58(2):211-8
references.pmid: 21765362
references.citation: AIDS Care. 2010 Oct;22(10):1277-84
references.pmid: 20661789
references.citation: J Acquir Immune Defic Syndr. 2009 Mar 1;50(3):314-9
references.pmid: 19194310
references.citation: Vaccine. 2008 Feb 6;26(6):762-8
references.pmid: 18191881
references.citation: J Acquir Immune Defic Syndr. 2006 Feb 1;41(2):210-7
references.pmid: 16394854
references.citation: Sex Transm Infect. 2011 Oct;87(6):511-5
references.pmid: 21835763
references.citation: Bull World Health Organ. 2001;79(12):1133-7
references.pmid: 11799445
references.citation: J Acquir Immune Defic Syndr. 2005 Jul 1;39(3):359-64
references.pmid: 15980699
references.citation: J Acquir Immune Defic Syndr. 2004 Jun 1;36(2):721-5
references.pmid: 15167291
references.citation: N Engl J Med. 2009 Dec 3;361(23):2209-20
references.pmid: 19843557
references.citation: Trop Med Int Health. 2009 Feb;14(2):196-203
references.pmid: 19207177
references.citation: AIDS Care. 2011 Nov;23(11):1430-47
references.pmid: 21722022
references.citation: J Acquir Immune Defic Syndr. 2004 May 1;36(1):604-12
references.pmid: 15097304
references.citation: Int Marit Health. 2011;62(2):116-22
references.pmid: 21910115
references.citation: J Acquir Immune Defic Syndr Hum Retrovirol. 1997 Jun 1;15(2):165-71
references.pmid: 9241117
references.citation: Soc Sci Med. 2011 Jan;72(2):149-56
references.pmid: 21146910
references.citation: JAMA. 2010 Jul 21;304(3):275-83
references.pmid: 20639561
references.citation: J Acquir Immune Defic Syndr. 2001 Jul 1;27(3):281-8
references.pmid: 11464149
references.citation: PLoS One. 2013;8(1):e54523
references.pmid: 23336005
references.citation: Sex Transm Dis. 2012 Jun;39(6):433-9
references.pmid: 22592828
references.citation: Int J Epidemiol. 1999 Oct;28(5):964-74
references.pmid: 10597998
references.citation: J Acquir Immune Defic Syndr. 2001 Aug 1;27(4):381-8
references.pmid: 11468427
references.citation: AIDS Care. 2010 Apr;22(4):452-61
references.pmid: 20146113
references.citation: J Int AIDS Soc. 2012 Jun 14;15 Suppl 1:1-9
references.pmid: 22713352
references.citation: Vaccine. 2005 Feb 3;23(11):1351-8
references.pmid: 15661383
references.citation: Int J STD AIDS. 2004 Jul;15(7):479-83
references.pmid: 15228734