Abstract:
BACKGROUND. The high HIV prevalence and incidence in South Africa makes it suitable for recruitment of participants for large-scale HIV
preventive vaccine trials. However, fear of vaccine-induced seropositivity (VISP) may be a barrier for community acceptability of the trial,
for volunteers to participate in HIV preventive vaccine trials and for uptake of an efficacious vaccine. Prior to 2015, when the first phase
1 safety HIV vaccine trial was undertaken at Setshaba Research Centre, Soshanguve, the local community stakeholders and healthcare
workers were naive about HIV vaccine research and HIV preventive vaccines.
OBJECTIVE. To explore knowledge and perceptions regarding VISP among community stakeholders and healthcare workers in peri-urban
Soshanguve, Tshwane.
METHODS. Using a quantitative-qualitative mixed-methods study design, surveys (n=50) and in-depth interviews (n=18) were conducted during
July - August 2015. Participants included community stakeholders, community advisory board members and healthcare workers, who were
>18 years old and had attended community educational workshops during September 2014 - May 2015. Audio recordings of interviews were
transcribed verbatim and coded using content thematic analysis. Data were further analysed by sex, age and educational level.
RESULTS. Of a maximum score of 2 on knowledge on VISP, the 50 survey participants (mean age 33.78 years; 45 females) obtained an
average of 0.88 (44%). Of 17 in-depth interviewees (one interview could not be transcribed; mean age 30.9 years; 12 females), 8 (47%)
displayed some knowledge about VISP, of whom only 5 defined VISP correctly. Women were more knowledgeable about VISP than men;
5 of 12 women (42%) came close to defining VISP correctly, while none of the 5 men did so. The main fear of trial participation expressed
by most participants (n=6) was testing HIV-positive as a result of the vaccine. While some participants believed that the community’s
perceptions of VISP would negatively affect HIV vaccine trial support and recruitment efforts, others noted that if trial participants
understand the concept of VISP and are part of support groups, then they would have the information to combat negative attitudes within
their community.
CONCLUSION. Most participants had an inaccurate and incomplete understanding of VISP. Many feared testing HIV-positive at clinics;
therefore, education on improving a basic understanding of how vaccines work and why VISP occurs is essential. In addition, assessing
participant understanding of HIV testing, transmission and VISP is critical for recruitment of participants into HIV vaccine trials and may
improve acceptability of an HIV preventive vaccine.
