A social ecological model of willingness to participate in HIV vaccine trials among men who have sex with men in Chennai and Mumbai, India
Bibliographic record
Abstract
Recruitment of low- and middle-income country volunteers from most-at-risk-populations in HIV vaccine trials is essential to vaccine development. In India, men who have sex with men (MSM), at 20-fold higher risk for HIV infection than the general population, are a crucial population for recruitment. Research on willingness to participate (WTP) in HIV vaccine trials has focused predominantly on individual-level determinants (e.g., safety concerns, mistrust, altruism) in high-income countries. We used a social ecological framework to explore multi-level determinants of WTP among MSM in India. We conducted 9 focus groups (n=49) with low socioeconomic MSM (aged 20-46 years, mean=28), including peer outreach workers, in Chennai (in Tamil) and Mumbai (in Marathi/Hindi), and 7 key informant interviews with MSM community leaders and healthcare professionals. Focus groups/interviews were recorded, transcribed and translated into English. Two independent bilingual investigators conducted narrative thematic analysis using line-by-line coding and a constant comparative method, with member-checking by community representatives. Structural-level determinants of WTP included poverty, compensation for trial-related harms and having financially-dependent family members. Community-level factors were negative societal attitudes about same-sex sexuality and community engagement in HIV vaccine research. Interpersonal factors included anticipated peer and familial reactions and perceived HIV stigma. Individual-level determinants of WTP included knowledge about vaccines, openness about one’s sexuality and altruistic beliefs. WTP in HIV vaccine trials among MSM in India is associated with multi-level factors. Ubiquitous interpersonal and community-level concerns characteristic of the sociocultural context may complicate individual-focused conceptualizations of WTP. Interventions to reduce stigma and discrimination against MSM and PLHIV, capacity-building of MSM service organizations, and sustained and transparent communications tailored to the knowledge, concerns and educational level of local communities may support meaningful engagement of MSM in HIV vaccine trial preparedness. Attention to providing fair yet non-coercive compensation and healthcare benefits are warranted to support ethical conduct of trials.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".