Ugandans Highly Knowledgeable about HIV Vaccine and Willing to Participate in Future Trials

Education Still Necessary to Combat Vaccine Misconceptions

A majority of Ugandan study participants are familiar with the benefits of vaccines and are willing to participate in future HIV-preventive vaccine trails, according to a study conducted by researchers from the Johns Hopkins Bloomberg School of Public Health and other institutions. This is one of the first studies of its kind to assess the willingness of a general population in a developing country to participate in HIV vaccine trials. The Rakai district of Uganda is a potential site for phase 3 HIV-preventive vaccine trials in the future. Researchers also found that many study participants had multiple misconceptions about the disease and vaccines. The study, “Knowledge About Vaccines and Willingness to Participate in Preventive HIV Vaccine Trials: A Population-Based Study, Rakai, Uganda” was published in the June 1, 2004, issue of the Journal of Acquired Immune Deficiency Syndrome.

Ronald H. Gray, MBBS, MSc, co-author of the study and a professor in the School’s Department of Population and Family Health Sciences, said, “There is a high level of willingness to participate in HIV vaccine research in this population. However, initiation of vaccine trials will require intensive education efforts to dispel misconceptions and irrational fears about adverse effects on fertility.”

The researchers completed initial and follow-up interviews with 10,312 people in Rakai, Uganda, aged 15-49 years. In between interviews, the study participants were educated on vaccines in general and potential HIV-preventive vaccines. Seventy-one percent of the study population was aware of the preventive function of vaccines and 77 percent were willing to participate in HIV-preventive vaccine trials. The researchers also learned that most of the study participants thought vaccines were only appropriate for children and women. Only 28 percent of those interviewed thought adult men could receive vaccines and 61 percent of male study participants thought men should not receive vaccines. The researchers hypothesized that this belief is typical because vaccinations in the area are mainly given to children and pregnant women. Almost 8 percent of participants thought vaccines were lethal and 2 percent thought vaccines caused fever/illness. In addition, only 12 percent of those interviewed thought HIV was a serious problem, even though Rakai has a 15 percent prevalence of the disease.

The researchers found that village-based health meetings worked in educating study participants on HIV vaccines. The researchers said they believe village meetings would be effective in the future to reinforce the seriousness of the AIDS epidemic and to educate the community on vaccines. HIV vaccine awareness increased from 68 percent at the time of the first interview to 81 percent at follow-up meetings. Even after emphasizing preventive vaccines, 60 percent of study participants still thought that HIV-infected individuals could participate in vaccine trials.

“Although vaccine knowledge and willingness to participate in trials are high in this population, there is still a need for education on the severity of the HIV/AIDS epidemic, the role of potential, preventive HIV vaccines and the importance of vaccines for men,” said Dr. Gray.

The study was supported by grants from the Department of the Army, United States Army Medical Research and Material Command Cooperative Agreement, Henry M. Jackson Foundation and Fogarty Foundation.

Noah Kiwanuka, MD, ChB, MPH, Merlin Robb, MD, Godfrey Kigozi, MB, ChB, MPH, Deborah Birx, MD, MS, James Philips, MD, PhD, Fred Wabwire-Mangen, MD, MPH, PhD, Maria J. Wawer, MD, MSc, Fred Nalugoda, Bstat, MHS, Nelson K. Sewankambo and David Serwadda coauthored the study.