Acceptability of a hypothetical preventative HIV vaccine among people who use drugs in Vancouver, Canada

Abstract

Background: As research on HIV vaccines continues to advance, studies exploring the feasibility of this intervention are necessary to inform uptake and dissemination strategies with key populations, including people who use drugs (PWUD). Methods: We conducted 25 in-depth qualitative interviews examining HIV vaccine acceptability among PWUD in Vancouver, Canada. Participants were recruited from an ongoing prospective cohort of HIV-negative PWUD. Data were coded using NVivo, and analyzed thematically. Results: Acceptability was framed by practical considerations such as cost and side effects, and was influenced by broader trust of government bodies and health care professionals. While an HIV vaccine was perceived as an important prevention tool, willingness to be vaccinated was low. Results suggest that future vaccine implementation must consider how to minimize the burden an HIV vaccine may place on PWUD. Centering the role of health care providers in information dissemination and delivery may assist with uptake. Conclusions: Our findings suggest improvements in care and improved patient-provider relationships would increase the acceptability of a potential HIV vaccine among this population.

Drug use and COVID-19 testing, vaccination, and infection among underserved, minority communities in Miami, Florida

“…Additionally, PWUD were more likely, compared to non-users, to have refused a vaccine in the past (COVID-19 vaccines among other vaccines). This supports the notion that drug use may be associated with hesitancy of other types of vaccines [ 22 – 26 ]. Although COVID-19 vaccines were, at the time, provided free-of-charge in the U.S., PWUD were more likely to report, “I don’t want to pay for it” than non-users, suggesting that immunization campaigns advertising vaccines as free regardless of insurance status [ 48 ], may not be reaching or be trusted by PWUD.…”

“…Studies investigating people who inject drugs have indeed reported lower COVID-19 vaccination rates in Australia and Baltimore, Maryland in the U.S. [ 18 , 21 ]. Reports of lower flu vaccine [ 22 , 23 ] and hepatitis A and B vaccine uptake [ 24 , 25 ], as well as low willingness for a potential HIV vaccine uptake among PWUD have also been published [ 26 ]. Nevertheless, data regarding COVID-19 vaccine uptake among PWUD in the Southern U.S. is lacking.…”

Acceptability of a future HIV vaccine: A rapid scoping review

“…77 Misinformation fueled strong skepticism toward the vaccine, which was predominantly framed by distrust in government, pharmaceutical companies in general, and adverse experiences within healthcare systems. 16,18,19,24,26,36,40,41,50,53,55,59,62,64,70,73,80 Participants in both high-and low-incidence populations expressed varying degrees of discomfort and suspicion about the hypothetical vaccine, as they believed that risks or toxicities of an HIV vaccine might not be fully disclosed to the public. Non-Hispanic Black women in a qualitative study conducted in Canada reported that governments and the medical community could not be trusted with the well-being of Black people, 36 and Indigenous Lesbian, Gay, Bisexual, and Transgender (LGBT) communities in another Canadian qualitative study indicated that fear of western "White man's medicine" demotivated their HIV vaccine acceptance.…”

“…Participants reported anticipated stigmatization of HIV/ AIDS as a major deterrent to HIV vaccine acceptance, and it was more frequently mentioned in studies of high-incidence populations 21,22,25,26,33,[35][36][37][38][39][40][41]50,53,56,70,71,73,78,80,87 compared with those of low-incidence populations. 51,66 Participants' fear of being labeled and judged by others as living with HIV, having multiple sexual partners, or engaging in risky behaviors increased their hesitancy and reduced acceptance of the HIV vaccine.…”

“…26 HIV stigma within MSM, IDUs, and LGBT communities was most studied in Canada, Thailand, and the United States. 25,33,35,36,39,40,50,53,56,70,71,73,80,87 Regarding HIV stigma, they expressed concern about the social risks of receiving an HIV vaccine. They believed that their acceptance of the vaccine may exacerbate stigmatization and harm high-incidence groups, especially when pervasive anti-gay and anti-AIDS sentiments were already hindering existing HIV prevention efforts and when HIV-positive Black persons and sex workers were already subject to substantial discrimination, even in healthcare settings.…”