Female sex workers perspectives on participating in a HVTN vaccine preparedness trial in the Dominican Republic
B. Clio1, L. Moreno2, Y. Donastorg2, M. Perez3, A. Giroux4, D. Kerrigan5, C. Barrington1
1University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, United States, 2Unidad de Vacunas IDCP-COIN-DIGECITSS, Santo Domingo, Dominican Republic, 3Unidad de Vacunas IDCP-COIN-DIGECITSS, Santo Domigo, Dominican Republic, 4National Human Genome Research Institute, National Institutes of Health, Bethesda, United States, 5Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
Background: HIV Vaccine Trials Network Protocol 903 preparedness trial was conducted in the Dominican Republic to evaluate local capacity to recruit and retain individuals at high risk for HIV infection, a necessary prerequisite for future HIV vaccine trials. The trial was implemented through a tri-institution collaborative including a non-profit medical institution, a community-based NGO that provides HIV preventive services to female sex workers (FSW), and the Ministry of Health. The purpose of this qualitative study was to describe the FSW perspectives on the impact participating in Protocol 903.
Methods: Qualitative in-depth interviews using a semi-structured guide were conducted in 2006 with 24 FSW at the end of their participation in Protocol 903. Data analysis included multiple readings of transcripts to identify key themes, coding with Atlas.ti qualitative software, and development of matrices to compare findings within and across participants.
Results: Protocol 903 included periodic clinical appointments and HIV counseling, workshops on HIV prevention, and social events with participants' families. Through these activities participants described strengthening their safe-sex negotiation skills and developing an enhanced sense of self-worth. Participants also described their participation as part of a collective movement to overcome marginalization and contribute to the advancement of scientific research. However, interviews revealed lingering confusion about the purpose of the protocol, whether the trial actually included a vaccine, and whether a vaccine would cure or prevent HIV.
Conclusions: Participation in Protocol 903 was meaningful for participants beyond the clinical and logistical outcomes. A key component of the trial experience for FSW in the Dominican Republic was the involvement of a known and trusted NGO. Future trials must improve health education to address lingering confusion about HIV vaccine research. Qualitative inquiry should be included in HIV-related biomedical research to assess the impact of trial participation and aid in the interpretation of quantitative behavioral assessments.
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