title: Willingness to participate in HIV vaccine trials among men who have sex with men in Chennai and Mumbai, India.
abstract: BACKGROUND
  Men who have sex with men (MSM) are at disproportionately high risk for HIV in India and would benefit greatly from a safe and effective HIV vaccine. We assessed willingness to participate (WTP) in HIV vaccine trials and the impact of various trial characteristics on WTP among MSM in Mumbai and Chennai.
  
  
  METHODS
  We used venue-based time-space sampling to recruit MSM at cruising sites and drop-in centers at community-based organizations. Structured survey interviews assessed sociodemographics, WTP and the impact of 10 trial characteristics on WTP. We tested for differences in WTP by sociodemographics and trial characteristics, and sociodemographic differences in the impact of trial characteristics on WTP.
  
  
  RESULTS
  Among 400 participants (median age=25 years), 46.9% identified as kothi, 40.0% panthi/double-decker, 13.0% gay/bisexual; 29.0% had primary school education or less; and 40.0% had monthly income <=5000 INR (∼3USD/day). Overall, 48.1% reported being definitely willing to participate. Posttrial availability of an efficacious vaccine was the highest rated (90.98 on 100-point scale) trial characteristic, followed by availability of free medical treatment (90.79), life insurance (89.84) and side effects (79.81). Distance to the trial site, side effects, financial incentive, life insurance and free medical care had significant impacts on WTP, with differential importance of trial characteristics by sexual identity, education, income and living arrangement.
  
  
  CONCLUSIONS
  The prioritization of trial-related financial and healthcare provisions, including access to an efficacious vaccine posttrial, among MSM in India indicates the importance of trials providing such services, as well as the value of formative research in identifying key concerns among participating communities in resource-limited settings. The significant impact of trial characteristics on WTP suggests that providing trial benefits deemed fair and important, addressing logistical concerns, and supporting educational interventions to mitigate vaccine fears may support recruitment of MSM in India in fairly and ethically conducted HIV vaccine trials.
authors.affiliation: Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1V4. Electronic address: p.newman@utoronto.ca.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Newman
authors.affiliation: Centre for Sexuality and Health Research and Policy, 38 Rangarajapuram Main Road, Kodambakkam, Chennai 600 024, Tamil Nadu, India; The Humsafar Trust, 3rd Floor, Manthan Plaza, Nehru Rd., Vakola, Santacruz (East), Mumbai 400055, India.
authors.forename: Venkatesan
authors.initials: V
authors.lastname: Chakrapani
authors.affiliation: Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1V4.
authors.forename: James
authors.initials: J
authors.lastname: Weaver
authors.affiliation: Centre for Sexuality and Health Research and Policy, 38 Rangarajapuram Main Road, Kodambakkam, Chennai 600 024, Tamil Nadu, India.
authors.forename: Murali
authors.initials: M
authors.lastname: Shunmugam
authors.affiliation: Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1V4.
authors.forename: Clara
authors.initials: C
authors.lastname: Rubincam
mesh_terms: D016915:AIDS Vaccines; D000328:Adult; D003710:Demography; D018451:Homosexuality, Male; D006801:Humans; D007194:India; D008297:Male; D009042:Motivation; D010358:Patient Participation / Q000706:statistics & numerical data*
chemical_list: D016915:AIDS Vaccines
keywords: Bioethics; HIV vaccine trials; India; Men who have sex with men; Posttrial services; Willingness to participate