Pediatric HIV type 1 vaccine trial acceptability among mothers in Kenya

Area of Science:

• Immunology
• Public Health
• Pediatric Infectious Diseases

Background:

• Mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) remains a significant global health challenge.
• Preventive strategies, including infant vaccination, are crucial for controlling HIV-1 spread.
• Successful pediatric HIV-1 vaccine trials and immunization programs depend on community acceptance and participant willingness.

Purpose of the Study:

• To assess pregnant women's attitudes toward infant vaccination and participation in human immunodeficiency virus type 1 (HIV-1) vaccine research.
• To identify factors influencing willingness to enroll infants in pediatric HIV-1 vaccine trials.
• To understand barriers to participation in HIV-1 vaccine research among women at high risk.

Main Methods:

• A cross-sectional study was conducted with pregnant women attending a routine antenatal clinic in Nairobi.
• Participants (n=805) were interviewed about their willingness to vaccinate their infants against HIV-1 and enroll them in research studies.
• Factors associated with willingness to participate in HIV-1 vaccine trials were analyzed using univariate and multivariate models.

Main Results:

• A high proportion of women (97%) would vaccinate their infant against HIV-1, and 91% were willing to enroll them in research.
• Willingness to enroll decreased if frequent HIV-1 testing (80%) or trial participation (64%) was required.
• Major concerns included side effects (75%), partner objection (34%), and fear of discrimination or HIV-1 acquisition.
• Maternal willingness to participate in vaccine trials was the strongest predictor of infant trial participation (HR 17.1).

Conclusions:

• Infant immunization against HIV-1 and participation in pediatric vaccine trials are generally acceptable to women at high risk in Nairobi.
• Addressing identified barriers, such as side effects and partner objections, is essential for successful implementation.
• Engaging male partners and communities is critical for mobilizing participation in future HIV-1 vaccine trials and immunization programs.