First generation of HIV vaccines may be available within 10 years but availability doesn't guarantee uptake

Public health officials must be sensitive to concerns about stigma and fear of vaccine-induced infection if they want women to take advantage of HIV vaccines now under development, says a University of Toronto researcher.

"The first generation of HIV vaccines may be available within 10 years but availability doesn't guarantee uptake," says U of T social work professor Peter A. Newman, one of the authors of a study in the June AIDS Education and Prevention. "Health-care officials must begin preparing now to address the social, behavioural and biological barriers they are likely to encounter in disseminating a future vaccine."

Through a series of focus groups with both health-care providers and women from at-risk populations in Los Angeles, Newman and colleagues from the University of California at Los Angeles and the Los Angeles County Health Department identified barriers to future HIV vaccine acceptance. In addition to worries about being labelled gay or promiscuous if they are vaccinated and fear of contracting HIV/AIDS from the vaccine, women in the focus groups were also concerned about power dynamics (the influence of husbands who are in denial about their own risk behaviours), affordability, reproductive side effects and discrimination in obtaining the vaccine.

However, the women also identified some strong motivations for getting vaccinated. Many viewed it as empowering to be able to protect themselves against HIV infection and others were eager to ensure their children were also protected. Both women and providers suggested that the vaccine be delivered as part of routine care so women would be able to take advantage of its protection without having to confront their partners and wouldn't have the stigma of obtaining care from HIV-identified services.

"These are all important factors to consider when a future vaccine is rolled out," says Newman. "Vaccines must be easy to obtain and affordable and women's particular concerns must be addressed or HIV vaccines will have limited success among the people most vulnerable to infection."