Inoculating and boosting against HIV vaccine misinformation among adolescent girls and young women in South Africa

项目总结 几十年来，安全、有效、负担得起、可接受的艾滋病毒疫苗一直是结束疫情的目标， 近年来，在开发和测试有希望的候选疫苗方面取得了实质性进展。 对于撒哈拉以南非洲的青春期女孩和年轻妇女等高度弱势群体，获得和 接种疫苗对于减少近年来观察到的异常高的艾滋病毒发病率至关重要。 这在南非尤其如此，南非拥有世界上最大的艾滋病毒疫情和几种活性艾滋病毒疫苗 试验计划。虽然艾滋病毒疫苗有可能大幅降低艾滋病毒风险，但实现这一潜力将 需要广泛接种疫苗。不幸的是，艾滋病毒流行和 正在进行的新冠肺炎大流行为有关艾滋病毒的错误信息的传播奠定了基础 疫苗。艾滋病毒疫苗的可能属性(例如，对艾滋病毒的部分保护)，对政府和 医学研究机构，以及对疫苗如何起作用的理解不足，将离开艾滋病毒疫苗计划 在将从疫苗诱导的保护中受益最大的人群中容易受到错误信息的影响。 为了实现未来艾滋病毒疫苗的好处，需要新的沟通策略来“接种” 艾滋病毒感染风险最高的个人防止传染性疫苗错误信息。在这项研究中，我们带来了 两种很有希望的方法--心理接种理论和行为经济学--一起对抗艾滋病毒 疫苗错误信息。心理接种理论为建立“抵抗力”提供了一种令人信服的方法 通过显性地暴露于虚假的“弱化”版本(通过直接驳斥)来接种错误信息 错误信息背后的论据，在遇到更强烈版本的错误信息之前。重要的是 通过 假设 揭穿 预先储备(或先发制人地警告个人)正在出现的错误信息，接种理论也 这将更好地防止未来的错误信息。预填料避免了更大的挑战 一旦错误信息传出。此外，行为经济学还提供了一个补充 认识到个人面临的认知和注意力限制的框架，并可以提供更多信息 有效的接种信息。我们提出了一项关于接种信息的随机对照试验 行为经济学在南非AGYW的推动下，一个高度易受艾滋病毒感染的人群 并预防错误信息的传播。与疫苗试验类似，我们的行为试验将评估疫苗的有效性、安全性、 行为经济学促进的接种信息的持久性和普遍免疫效应 洞察力。我们还将评估AGYW重要分组对这些信息的不同反应。这 概念验证项目有可能确定创新的沟通策略，以建立对 新出现的和不断演变的艾滋病毒疫苗错误信息。这项研究的结果将推动艾滋病毒的科学研究 疫苗需求创造和基于接种理论的疫苗沟通方法。

PROJECT SUMMARY A safe, effective, affordable and acceptable vaccine against HIV has been an epidemic-ending goal for decades, and recent years have seen substantial progress towards developing and testing promising candidate vaccines. For highly vulnerable groups like adolescent girls and young women (AGYW) in sub-Saharan Africa, access and uptake of vaccines will be essential for reducing the exceptionally high HIV incidence observed in recent years. This is particularly true in South Africa, which has the world's largest HIV epidemic and several active HIV vaccine trial programs. While an HIV vaccine has the potential to substantially reduce HIV risk, realizing this potential will require widespread vaccine uptake. Unfortunately, the lived experiences of both the HIV epidemic and the ongoing COVID-19 pandemic have laid the groundwork for an infodemic of misinformation about the HIV vaccine. Likely attributes of the HIV vaccine (e.g., partial protection against HIV), low trust in governmental and medical research institutions, and poor understanding of how vaccines work will leave an HIV vaccine program vulnerable to misinformation among the populations who would most benefit from vaccine-induced protection. To realize the benefits of future HIV vaccines, novel communication strategies are needed to “inoculate” individuals at highest risk of HIV infection against contagious vaccine misinformation. In this study, we bring together two promising approaches – psychological inoculation theory and behavioral economics – to fight HIV vaccine misinformation. Psychological inoculation theory offers a compelling approach to building “resistance” to vaccine misinformation through explicit exposure to a “weakened” version (via direct refutation) of false arguments underlying misinformation, before stronger versions of misinformation are encountered. Importantly, by posits debunking prebunking (or pre-emptively warning individuals about) emerging misinformation, inoculation theory also that t hey will be better able to r esist future misinformation. Prebunking avoids the greater challenge of once misinformation has lodged. In addition, behavioral economics provides a complementary framework that recognize the cognitive and attentional constraints faced by individuals and can inform more effective inoculation messages. We propose a randomized controlled trial of inoculation messages with a behavioral economics “boost” with AGYW in South Africa, a population highly vulnerable to both HIV infection and to vaccine misinformation. Mirroring a vaccine trial, our behavioral trial will evaluate the efficacy, safety, durability, and generalized immunity effects of inoculation messages that are boosted with behavioral economics insights. We will also evaluate differential responses to the messages by important subgroups of AGYW. This proof--of-concept project has the potential to identify innovative communication strategies to build resistance to emerging and evolving HIV vaccine misinformation. Results from the study will advance the science of HIV vaccine demand creation and inoculation-theory based approaches to vaccine communication.