Post-trial HIV Vaccines: Receptivity, Risk & Disparities

描述(由申请人提供)：由于美国每年有40,000人感染艾滋病毒，开发和传播有效的艾滋病毒疫苗是一个主要的科学和公共卫生目标。这项提议寻求资金，以对高危人群进行研究，以促进艾滋病毒疫苗试验后的最佳未来传播，并最大限度地发挥疫苗帮助控制艾滋病毒流行的潜力。具体目标是：1)检查消费者对艾滋病毒疫苗的可接受性和改变艾滋病毒危险行为的意图，以及可接受性和意图如何随假想疫苗的属性(例如，疗效、副作用、成本等)而变化；2)检查试验后艾滋病毒疫苗的可接受性和风险行为意图及其与疫苗属性的关系如何随社会人口特征、艾滋病毒疫苗知识以及疫苗接种的障碍和激励因素而变化；3)使用结构方程模型，检验从理论中得出的一系列独立变量对HIV疫苗可接受性和风险行为意向的直接和间接影响：社会人口学特征、过去的卫生保健经验、过去的HIV危险行为、过去的HIV检测行为、过去的疫苗接种量、HIV疫苗知识、障碍和激励因素。 为了达到这些目标，我们将对洛杉矶三种类型的场所--性传播疾病诊所、针头交换计划和拉丁裔社区卫生和艾滋病毒预防诊所--进行一项具有代表性的、人口统计学上不同的1200人样本的调查。我们将使用联合分析来评估试验后艾滋病毒疫苗的可接受性和改变危险行为的意图，联合分析是一种越来越多地用于健康研究的技术。提出了具有不同水平的七种二分属性(有效性、副作用、保护期限、剂量数量、路线、亚型数量、成本)的假设HIV疫苗，以引起关于疫苗接种率和风险行为变化的疫苗偏好和意图。意向将根据受访者的特征进行比较，例如，拉美裔人对政府的不信任是否导致他们对艾滋病毒疫苗的接受度较低。这一分析的结果将使我们能够制定针对目标人群的经验性、以消费者为基础的社会营销和公共卫生教育战略，并将有助于指导公共卫生机构实现未来艾滋病毒疫苗的最佳传播。

DESCRIPTION (provided by applicant): As 40,000 persons contract HIV each year in the U.S., developing and disseminating effective HIV vaccines is a primary scientific and public health objective. This proposal seeks funding to conduct research on populations at risk to facilitate optimal future post-trial dissemination of HIV vaccines and maximize the vaccines' potential to help control the HIV epidemic. The specific aims are: 1) To examine consumer acceptability of HIV vaccines and intentions to change HIV risk behaviors, and how acceptability and intentions vary with attributes of the hypothetical vaccines (e.g., efficacy, side effects, cost, etc.); 2) To examine how post-trial HIV vaccine acceptability and risk behavior intentions, and their relationship to vaccine attributes, vary with sociodemographic characteristics, HIV vaccine knowledge, and barriers to and motivators for vaccine uptake; and 3) To examine the direct and indirect effects on HIV vaccine acceptability and risk behavior intentions of a broad range of independent variables derived from theory: sociodemographic characteristics, past health care experiences, past HIV risk behaviors, past HIV testing behaviors, past vaccine uptake, HIV vaccine knowledge, barriers, and motivators, using structural equation modeling. To address these aims, we will conduct a survey of a representative, probability sample of 1200 demographically diverse persons attending three types of venues in Los Angeles: Sexually Transmitted Disease Clinics, Needle Exchange Programs, and Latino Community Health and HIV Prevention Clinics. We will assess the acceptability of post-trial HIV vaccines and intentions to change risk behaviors using conjoint analysis, a technique increasingly used in health research. Hypothetical HIV vaccines with different levels of seven dichotomous attributes (efficacy, side effects, duration of protection, number of doses, route, number of subtypes, cost) are presented to elicit vaccine preferences and intentions regarding vaccine uptake and changes in risk behavior. Intentions will be compared across respondents' characteristics, e.g., whether Latinos' distrust of government mediates their lower acceptability of HIV vaccines. Results of this analysis will enable us to develop empirical, consumer-based social marketing and public health education strategies tailored to target populations, and will help guide public health agencies toward optimal dissemination of future HIV vaccines.