Willingness to participate (WTP) in a future HIV vaccine trial in a high risk sample : perceived barriers and facilitators to participation
Thesis (MSc (Psychology))--University of Stellenbosch, 2006.
HIV vaccines are currently being developed and tested worldwide. This thesis reports on a qualitative study that was conducted to determine the concerns and problems regarding participation in future HIV vaccine trials. The sample for the study was selected from a peri-urban township, Masiphumelele, in Cape Town, Western Cape province, South Africa. The HIV-prevalence rate in Masiphumelele is 25%. A total of 10 participants between the ages of 19 and 30 were recruited for the present study. All participants’ first language was Xhosa and seven of them had English as a second language. Owing to a language barrier, an interpreter assisted the interviewer in conducting the interviews in the preferred language of the participants. Participants were recruited by convenience sampling and were asked to participate in two semi-structured interviews, under confidential conditions. The first interview addressed knowledge regarding HIV/AIDS, HIV vaccines and HIV clinical trials. The second interview identified the concerns and problems participants had regarding participation in future HIV vaccine trials. The interviews were recorded, transcribed and entered into Atlas ti., a computer program that assists in the analysis of textual data. The analysis of the data focused on the content of participants’ concerns about barriers to participation and their perspectives on facilitators to participation. The data collected on concerns and problems which, may influence participants’ willingness to participate in future HIV vaccine trials, was divided into two overarching themes, namely, barriers to participation and facilitators to participation. The barriers to participation included physical symptoms, stigma and discrimination, trypanophobia, distrust, psychological distress, sexual disinhibition and family responsibilities. The facilitators to participation included altruism, own protection from HIV infection, hopefulness, medical incentives, determining of HIV status, acquisition of knowledge, and equal treatment of participants in the experimental group and the placebo control group resulting from a double-blinded randomised trial. The question of participants’, recruited in the present study, willingness to participate in a future HIV vaccine trial are discussed in terms of Bronfenbrenner’s (1979) theoretical work on ecological systems, the social learning theory and the Health Belief Model (HBM). These theoretical frameworks deal with individuals, their behaviour and their environment, and how these influence one another. The significance and future direction of this line of research helps to overcome the barriers to participation and enhance the facilitators to participation. Thus, the intended result of such efforts is to maximise individuals’ participation in future HIV vaccine trials.