Hepatitis B immunization: a potential incentive to HIV vaccine trial participation in Thailand?

To assess the effectiveness of hepatitis B immunization as an incentive to retention in HIV seroincidence studies and future HIV vaccine trials in northern Thailand, subjects enrolled in three HIV seroincidence cohorts were screened for hepatitis B markers and seronegatives were offered free hepatitis B immunization. Cohorts studied included female commercial sex workers (CSWs), male sexually transmitted disease (STD) patients, and recently discharged military conscripts. Subjects who agreed to the immunization program were compared with those not enrolled to determine the utility of immunization as an incentive to cohort retention. Full immunization was achieved for 273 (89.5%) of 305 vaccinees; only 323 (60.6%) of 533 subjects not immunized completed the same follow-up visits (OR = 1.49, 95% and CI = 1.27, 1.75). Hepatitis B vaccination was a significant incentive for completion of the follow-up program. The vaccination program had the greatest effect on the CSWs; a similar effect was seen for male STD patients, but not for discharged conscripts. Despite the immunization program, follow-up rates at 12 months were similar in the immunized and nonimmunized groups.