Development of an HIV vaccine attitudes scale to predict HIV vaccine acceptability among vulnerable populations: L.A. VOICES

Abstract

Background Decade-long delays in successful implementation of Hepatitis B vaccines and ongoing obstacles in HPV vaccine roll-out suggest the importance of an implementation science approach to prepare for the effective translation of future HIV vaccines from clinical trials into routine practice. The objective of this study wasto test HIV vaccine attitude items to develop reliable scales and to examine their association with HIV vaccine acceptability. Methods HIV vaccine attitude items were assessed as part of the L.A. VOICES survey, a large-scale study conducted among underserved residents of Los Angeles, to identify factors that may influence HIV vaccine acceptability. Participants (n=1,225) were randomly selected from public STD clinics, needle exchange sites and Latino community clinics using three-stage, venue-based time space sampling. Results Exploratory factor analysis across 20 items revealed four distinct factors—mistrust, HIV vaccine social concerns, risk compensation, and altruistic vaccination—with acceptable reliability coefficients for each subscale (Cronbach’s α range 0.61 – 0.84). We found no significant differences in reliability by gender or by vaccine acceptability. Risk compensation (Odds Ratio (OR) =1.49; 95% CI=[1.18, 1.89]; p=0.001) and altruistic vaccination (OR=1.40; 95% CI=[1.14, 1.71]; p=0.001) were significantly and positively associated with HIV vaccine acceptability. Conclusions We identified four HIV vaccine attitude scales with sound internal reliability parameters. In the aftermath of the first candidate vaccine to demonstrate efficacy against HIV infection, these scales may be helpful in bridging expectable research-to-practice gaps in future HIV vaccine dissemination among populations at risk. As HIV vaccine trials progress in the United States and globally, these measures also may be useful as a tool to assess and facilitate effective responses to community concerns about HIV vaccine trials and to target interventions to support recruitment and mitigate risk compensation.

Sexual behavior, risk perception and HIV transmission can respond to HIV antiviral drugs and vaccines through multiple pathways

“…The survey randomly sampled individuals attending STD clinics and needle exchange sites. Risk compensation was found to be positively and significantly associated with vaccine acceptability, indicating individuals open to adopting the HIV vaccine perceived less of a need for protection through condom use 15 .…”

COVID-19 Vaccine Acceptance among an Online Sample of Sexual and Gender Minority Men and Transgender Women

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Framing a Consent Form to Improve Consent Understanding and Determine How This Affects Willingness to Participate in HIV Cure Research: An Experimental Survey Study

“…A brief optional demographic questionnaire was used to collect information on age, date of HIV diagnosis, sexual orientation, and race/ ethnicity. For a covariate, given the strength of relationship of altruism with research participation, we administered the Altruism subscale from the HIV Vaccine Attitude Measure (Lee et al, 2014). The subscale included four items that capture a person's motivation to participate in an HIV vaccine study, which were adapted for the HIV cure research context.…”