Survey uncovers surprising attitudes towards HIV vaccine research

A survey of U.S. adults has found that a majority believe that HIV vaccines are the best hope for controlling the global AIDS epidemic and are confident such vaccines can be made. But while most of those surveyed felt it personally important to help support HIV vaccine research, a majority expressed reluctance to support a friend or family member’s participation in an HIV vaccine clinical trial.

These were among the conflicting findings of a telephone survey of more than 3,500 adults to assess attitudes, knowledge and awareness of HIV vaccine research in the United States. The survey, conducted by members of the HIV Vaccine Communications Campaign of the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, points to the ongoing challenges HIV vaccine researchers face. A paper on the survey results is available online now and will be published in an upcoming print issue of the Journal of Acquired Immune Deficiency Syndromes.

“Tens of thousands of volunteers are required for the more than 30 HIV vaccine clinical trials currently planned or under way,” says NIAID director Anthony S. Fauci, M.D. “It is essential that current and future trials involve volunteers from diverse communities to enable us to find a vaccine that works for all populations.”

“It is clear that we have a lot of work to do in explaining HIV vaccine research,” adds paper co-author Matthew Murguía, director of the Office of Program Operations and Scientific Information in the NIAID Division of AIDS. “We must develop strong partnerships with communities highly impacted by HIV/AIDS so individuals from these communities can make informed decisions about participating in HIV vaccine research.”

The survey, conducted between December 2002 and February 2003, polled 2,008 U.S. adults, 18 or older, randomly selected from the general population. An additional 1,501 U.S. adults interviewed were randomly selected from each of three specific subpopulations highly affected by HIV–African Americans, Hispanics and men who have sex with men.

The survey uncovered some unexpected attitudes and beliefs:

• 47 percent of African Americans, 26 percent of Hispanics, 13 percent of men who have sex with men and 18 percent of the general population believe that an HIV vaccine already exists but is being kept a secret.
• Most subpopulation respondents–78 percent of African Americans, 68 percent of men who have sex with men and 57 percent of Hispanics–either do not know whether or incorrectly believe that the vaccines being tested can cause HIV infection. Only 24 percent of the general population responded comparably.
• Among men who have sex with men, 77 percent cited HIV/AIDS as the most urgent health problem. Only a small percentage of the other groups surveyed, however, agreed: 11 percent of Hispanics, 15 percent of the general population and 22 percent of African Americans.
• In general, women had less knowledge and awareness than men about HIV vaccine research.
• High percentages of each group felt it was important to personally support HIV vaccine research: 89 percent of both Hispanics and of men who have sex with men, 86 percent of African Americans and 73 percent of the general population. Nonetheless, many were reluctant to express strong support for friends or family members volunteering for HIV vaccine trials. Only 29 percent of the general population and 35 percent of African Americans said they would be extremely or very supportive. Hispanics and men who have sex with men were more inclined to be supportive: 46 percent and 68 percent, respectively.

The NIAID team also assessed trust in the U.S. government’s ability to protect HIV vaccine trial volunteers. While about half of three groups–men who have sex with men (50 percent), African Americans (55 percent) and the general population (57 percent)–said they could trust the government to protect HIV vaccine trial volunteers, the rate of trust among Hispanics was significantly higher at 78 percent.

Based on interviews, focus groups and media analysis, NIAID team members first developed five key messages on vaccine research. They then designed the survey to determine whether these key messages were the most important ones for the HIV Vaccine Communications Campaign to address. These key messages were:

• There is currently no vaccine to prevent HIV infection.
• Only HIV-negative individuals can volunteer for a preventive HIV vaccine trial.
• You cannot become infected with HIV from the vaccines being tested.
  All populations must be involved in HIV vaccine research.
• An HIV preventive vaccine, complemented by strong behavioral prevention programs and AIDS care and treatment, is the best way to end the epidemic.

The results of the survey, says Mr. Murguía, have helped identify which populations researchers need to target for better understanding of HIV vaccine research, as well as which messages need to be tailored to specific populations. The NIAID team will work to lower the barriers that inhibit potential volunteers from diverse populations from participating in HIV vaccine trials and to increase community support for those who volunteer for a trial.

NIAID is a component of the National Institutes of Health, an agency of the U.S. Department of Health and Human Services. NIAID supports basic and applied research to prevent, diagnose and treat infectious diseases such as HIV/AIDS and other sexually transmitted infections, influenza, tuberculosis, malaria and illness from potential agents of bioterrorism. NIAID also supports research on transplantation and immune-related illnesses, including autoimmune disorders, asthma and allergies.