Sexual risk behaviour of Canadian participants in the first efficacy trial of a preventive HIV-1 vaccine

Lampinen, Thomas M.

doi:10.1503/cmaj.1031785

Cited by 22 publications

(15 citation statements)

References 12 publications

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“…4 Studies examining attitudes and behaviors in the context of human immunodeficiency virus (HIV) vaccines 5–7 and treatment 8,9 show conflicting results in terms of whether participants perceive themselves to be at less risk for HIV infection and practice riskier behaviors after these interventions. However, behavioral responses to HIV prevention and treatment may not be applicable to HPV vaccination.…”

mentioning

confidence: 99%

Adolescent Perceptions of Risk and Need for Safer Sexual Behaviors After First Human Papillomavirus Vaccination

Mullins

Zimet

Rosenthal

et al. 2012

Arch Pediatr Adolesc Med

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mentioning

confidence: 99%

Adolescent Perceptions of Risk and Need for Safer Sexual Behaviors After First Human Papillomavirus Vaccination

Mullins

Zimet

Rosenthal

et al. 2012

Arch Pediatr Adolesc Med

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“…18,20,[23][24][25][26][27] Although decreases in individual risk behavior would augment the population benefits of such vaccination programs in terms of HIV infections prevented, increases in risk behavior might negate those benefits or even worsen the HIV epidemic. Although we are unable to predict what might occur in a future mass vaccination campaign, 7 results from the few completed vaccine trials to date in North America, Europe, and Asia show that risk behavior generally did not increase, [28][29][30][31][32] despite early reports of increased risk behavior in several small trials. 33 Nine African countries are preparing or already enrolling participants for HIV vaccine trials, 2,34,35 however, and preliminary studies indicate that sexual risk behavior might increase in response to vaccination.…”

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confidence: 99%

Predicting the Impact of a Partially Effective HIV Vaccine and Subsequent Risk Behavior Change on the Heterosexual HIV Epidemic in Low- and Middle-Income Countries

Andersson

Owens²,

Vardas³

et al. 2007

JAIDS Journal of Acquired Immune Deficiency Syndromes

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SummaryWe developed a mathematical model to simulate the impact of various partially effective preventive HIV vaccination scenarios in a population at high risk for heterosexually transmitted HIV. We considered an adult population defined by gender (male/female), disease stage (HIVnegative, HIV-positive, AIDS, and death), and vaccination status (unvaccinated/vaccinated) in Soweto, South Africa. Input data included initial HIV prevalence of 20% (women) and 12% (men), vaccination coverage of 75%, and exclusive male negotiation of condom use. We explored how changes in vaccine efficacy and post-vaccination condom use would affect HIV prevalence and total HIV infections prevented over a 10-year period. In the base-case scenario, a 40% effective HIV vaccine would avert 61,000 infections and reduce future HIV prevalence from 20% to 13%. A 25% increase (or decrease) in condom use among vaccinated individuals would instead avert 75,000 (or only 46,000) infections and reduce the HIV prevalence to 12% (or only 15%). Furthermore, certain combinations of increased risk behavior and vaccines with <43% efficacy could worsen the epidemic. Even modestly effective HIV vaccines can confer enormous benefits in terms of HIV infections averted and decreased HIV prevalence. However, programs to reduce risk behavior may be important components of successful vaccination campaigns. 4 Given the urgent need for an HIV vaccine, vaccines with only partial efficacy are likely to be used initially in populations at high risk for HIV infection. 5 The potential for post-vaccination risk-taking behavior to increase poses a significant threat to the successful use of partially effective vaccines in future vaccination programs. [5][6][7][8] Individuals might increase their risk-taking behavior, assuming they are completely protected from HIV when, in reality, they might have only limited protection or none at all. [9][10][11][12][13][14] Models have shown that even a partially effective HIV vaccine with minimal efficacy could have an enormous population impact on the HIV epidemic in high-risk groups or areas with a high prevalence of HIV, such as sub-Saharan Africa, [15][16][17][18][19][20][21][22] but that the magnitude of this impact depends on a fine balance between the efficacy of the vaccine, the vaccine coverage level, and the change in risky behavior. 18,20,[23][24][25][26][27] NIH Public Access MethodsWe developed a dynamic compartmental epidemic model for heterosexual HIV transmission and disease progression to simulate the impact of various partially effective preventive HIV vaccination scenarios and subsequent changes in risk behavior in a population at high risk for heterosexually transmitted HIV in Soweto, South Africa.* For this study, a preventive vaccine is defined as a vaccine that prevents primary infection with HIV, and a partially effective vaccine (low-efficacy vaccine, imperfect vaccine) is defined as a vaccine with less than 100% efficacy, or ability to prevent transmission of HIV. Model DescriptionThe model defines 6 "c...

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“…Van De Ven et al [35] similarly identified a “sexual freedom” scale in the context of willingness to participate (WTP) in HIV vaccine trials, with higher scores among higher risk MSM, and a significant positive association with WTP. However, behavioral data from HIV vaccine trials do not provide broad evidence of risk compensation [36–38], in that case due to preventive misconception—a belief that the experimental vaccine tested in a placebo-controlled trial will confer protection [36,39,40]. Yet risk behavior increases were identified among a subsample of MSM in the Vaxgen trial who tested for HIV against provisos from the trial, presumably to determine if they had received the experimental vaccine [36].…”

Section: Discussionmentioning

confidence: 99%

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

Lee¹,

Newman

Duan

et al. 2014

Vaccine

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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.

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Sexual risk behaviour of Canadian participants in the first efficacy trial of a preventive HIV-1 vaccine

Cited by 22 publications

References 12 publications

Adolescent Perceptions of Risk and Need for Safer Sexual Behaviors After First Human Papillomavirus Vaccination

Adolescent Perceptions of Risk and Need for Safer Sexual Behaviors After First Human Papillomavirus Vaccination

Predicting the Impact of a Partially Effective HIV Vaccine and Subsequent Risk Behavior Change on the Heterosexual HIV Epidemic in Low- and Middle-Income Countries

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

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