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项主要的科学和公共卫生目标。这项提案寻求资金，以便对有风险的人群进行研究，以促进今后试验后艾滋病毒疫苗的最佳传播，并最大限度地发挥疫苗帮助控制艾滋病毒流行的潜力。具体目的是：1)检查消费者对艾滋病毒疫苗的接受程度和改变艾滋病毒风险行为的意图，以及可接受程度和意图如何随假设疫苗的属性（如功效、副作用、成本等）而变化；2)研究试验后艾滋病毒疫苗可接受性和风险行为意愿及其与疫苗属性的关系如何随社会人口统计学特征、艾滋病毒疫苗知识以及疫苗接种的障碍和动机而变化；3)利用结构方程模型，研究从社会人口统计学特征、过去的卫生保健经历、过去的艾滋病毒风险行为、过去的艾滋病毒检测行为、过去的疫苗摄取、艾滋病毒疫苗知识、障碍和激励因素等理论推导的广泛自变量对艾滋病毒疫苗可接受性和危险行为意图的直接和间接影响。

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.