Theory-Based Analysis of Interest in an HIV Vaccine for Reasons Indicative of Risk Compensation Among African American Women

Abstract

Licensure of an HIV vaccine could reduce or eliminate HIV among vulnerable populations. However, vaccine effectiveness could be undermined by risk compensation (RC), defined by an increase in risky behavior due to a belief that the vaccine will confer protection. Interest in an HIV vaccine for reasons indicative of RC may serve as an indicator of actual RC in a postlicensure era. This study assessed factors associated with interest in an HIV vaccine for reasons indicative of RC among African American women aged 18 to 55 years, recruited from a hospital-based family planning clinic in Atlanta, Georgia ( N = 321). Data were collected using audio-computer-assisted surveys. Survey items were guided by risk homeostasis theory and social cognitive theory. Multivariable logistic regression was used to assess determinants of interest in an HIV vaccine for reasons indicative of RC. Thirty-eight percent of the sample expressed interest in an HIV vaccine for at least one reason indicative of RC. In the final model, interest in an HIV vaccine for reasons indicative of RC was positively associated with higher impulsivity, perceived benefits of sexual risk behaviors, and perceived benefits of HIV vaccination; it was negatively associated with having at least some college education, positive future orientation, and self-efficacy for sex refusal. Results suggest that demographic, personality, and theory-based psychosocial factors are salient to wanting an HIV vaccine for reasons indicative of RC, and underscore the need for risk-reduction counseling alongside vaccination during the eventual rollout of an HIV vaccine.

Acceptability of a future HIV vaccine: A rapid scoping review

“…Twenty articles were removed during the full-text review for the following reasons: full text not available, no results reported, no mention of HIV vaccine acceptance, and duplicate studies with conference abstract/ dissertation later published as an article. We identified a total of 76 studies as the [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]…”

“…Twenty-six studies 18,19,24,[31][32][33][34]41,47,50,53,61,62,66,68,70,71,73,76,78,80,82,83,[87][88][89] reported that perceived benefits of an HIV vaccine were associated with vaccine acceptance or one's willingness to participate in an HIV vaccine trial. The majority of high-incidence populations exhibited positive attitudes toward a future HIV vaccine, believing it could protect them against HIV and curb the HIV/AIDS pandemic.…”

“…In studies of low-incidence populations, participants often perceived vaccination as a way to decrease worry about getting HIV. 19,61,62 Adolescents and parents of adolescents would accept an HIV vaccine for protection against HIV, with a heightened awareness that HIV is increasingly prevalent among teenagers and that there is currently no cure for HIV. 68,89 As shown in Table 2, a greater number of studies of high-incidence populations identified HIV vaccine benefits as a reason for vaccine acceptability than those of low-incidence populations (37.0% vs. 27.3%).…”

Using immunisation caregiver journey interviews to understand and optimise vaccination uptake: lessons from Sierra Leone

“…Model have largely informed past assessments of vaccination attitudes, intentions and behaviours. [18][19][20][21][22][23][24][25][26] These expectancy-value theories do not adequately account for the dynamic role of caregivers' repeated experiences in shaping their vaccination behaviours. Recognising these limitations, various international partner organisations, under the leadership of UNICEF, developed the Immunisation Caregiver Journey Framework 27 as a novel way to contextualise and understand how caregivers and families navigate childhood immunisation services, especially in LMIC settings.…”

“…Expectancy-value theories such as the Health Belief Model have largely informed past assessments of vaccination attitudes, intentions and behaviours 18–26. These expectancy-value theories do not adequately account for the dynamic role of caregivers’ repeated experiences in shaping their vaccination behaviours.…”