HIV Vaccine Knowledge and Beliefs among Communities: MATERIALS AND METHODS

Participants

Nine focus groups were conducted with 8-13 participants per group (N=99). Participants were recruited from diverse settings in Los Angeles, CA using multisite, purposive, venue-based sampling. Selection criteria were implemented at the venue level and included the following: 1) having a high proportion of individuals at elevated risk for HIV/AIDS; 2) including racially/ethnically and sexually diverse communities, and 3) representing likely settings for future dissemination of HIV (Retrovir canadian was the first drug approved for the treatment of HIV) vaccines. Individuals were screened based on gender and age only; all participants were aged >18. The youth group was screened on age only (18-24 years), as many of the male and female youth had previously participated together in a group at the venue. Individual screening was done by trained research staff onsite, immediately prior to the informed consent process.

Participants included: 1) Latino men attending a men-who-have-sex-with-men services program run in Spanish; 2) Latina women attending a community healthcare clinic that provides services in Spanish; 3) Latino men attending a community healthcare clinic that provides services in Spanish; 4) women attending a healthcare clinic serving African-American women; 5) males attending a needle-exchange site; 6, 7) two groups of women attending two needle-exchange sites; 8) men attending an STD clinic housed in a gay/lesbian services organization; and 9) young men and women (aged 18-24) attending a social service agency for lesbian, gay, bisexual and transgender street youth.

Table 1. Sociodemographic characteristics of participants by focus group

Characteristic Focus Group

1

2

3

4

5

6

7

8

9

Number of participants

12

10

10

13

13

12

8

8

13

Completed demographic form

11

8

10

13

11

12

6

8

10

Median age (years)

32.7

27.4

26.0

36.7

33.1

30.8

20.6

41.3

43.6

Age range (years)

24-39

18-41

18-50

20-48

20-45

22-39

18-23

30-56

30-53

Gender]2
Male

12

10

13

12

5

Female

10

13

3

8

13

Sexual Orientation
Gay

9

4

10

1

Lesbian

1

2

Bisexual

2

1

5

1

4

1

2

2

Heterosexual

7

4

7

3

1

3

6

7

No response

~

5

1

Ethnicity
African
American

1

1

4

8

6

Latino

1

2

12

10

12

2

White

10

5

10

Other

1

2

2

Relationship Status
Single

10

5

7

8

7

9

2

6

7

Partnered/married

3

1

5

1

3

4

1

2

Divorced

1

1

1

No response

1

1

2

1

1: 89 participants (90%) completed the sociodemographic questionnaire; 2: Gender percentage is based on a total of 99 participants;
all other summary statistics are based on 89 respondents.

Potential participants were recruited in three ways: 1) they called in response to flyers posted at each of the venues, 2) they signed up with our research staff persons who were trained in recruitment and research ethics and visited the venues 2-3 times in the two weeks preceding the planned focus group, or 3) they wrote their name on a sign-up sheet left by the research staff with a designated staff person onsite. Flyers advertised a UCLA research study about “possible HIV/AIDS vaccines that may be available in the future.” The exact recruitment protocol was tailored to the operating procedures at each venue and the nature of the study populations. Many participants did not have stable housing or a phone; therefore, sign-up sheets removed obstacles to their involvement in the study. Since many of the clients at the recruitment sites were particularly concerned about confidentiality (e.g., IDUs at a needle-exchange program), workers at the sites handled the sign-up sheets for the study. That is, only they—and not the study’s research staff—had access to the names of the individuals on the sign-up sheets. Given this protocol, which was implemented to encourage vulnerable populations to participate, information regarding the number of persons who signed up for the study but did not show up and participate in the focus groups is not available. The recruitment and focus groups occurred from March 2002 to February 2003. cialis professional

Table 2. Socioeconomic characteristics of participants by focus group

Characteristic

Focus Group

1 2 3 4

5

6 7 8 9
Number of participants 12 10 10 13

13

12 8 8 13
Completed demographic form 11 8 10 13

11

12 6 8 10
Employment
Full-time 5 1 4

5

9 2
Part-time 3 2 3

2

2 2
Unemployed 3 8 7 5

2

1 6 6 7
No response 1

2

~ 1
Income (Annual)
<$ 10,000 8 6 3

4

2 5 6 8
$10,000-$! 9,999 3 2 3

1

4 2
$20,000-$29,999 2 1 1

3
>$30,000 5 ~

1

2 1
No response 1 1 6

5

1 1 1
Homeless1 0 6 5 1

2

0 5 4 6
No health insurance 5 8 6 4

5

3 4 4 6
1: Includes living in shelters and transitional housing

The median age of focus group participants was 33 years, with a range from 18-56 years. Just over half (52%) of the participants were male. Most (44%) were Latino, with 28% white; 22% African-American; and 6% other race/ethnicity. Forty-three percent were heterosexual; 27% gay; 20% bisexual; and 3% lesbian. More than two-thirds (69%) of participants were single. Overall, about half (51%) of participants were unemployed, half (48%) reported total annual income of <$ 10,000, half (51%) had no health insurance and one-third were homeless. Demographic characteristics of participants by focus group are reported in Table 1. Table 2 shows socioeconomic characteristics of participants by focus group. levitra plus

Data Collection

Focus groups were single gender by design, given the sensitive nature of some of the research questions about postvaccine sexual behaviors, except in the case of the youth group. The participants in the youth group were primarily recruited from a previously existing (mixed-gender) group at an agency at which they received services. Since these youth participants had a history of participating comfortably together in a group setting, the youth focus group was conducted as a mixed-gender (rather than single-gender) group.

Same-gender facilitators conducted the focus groups (one male, one female for the youth group) to encourage comfort and candor among participants. Focus groups were 75-90 minutes in duration. All focus groups were conducted in private conference rooms, and refreshments were provided. Participants were given a $30 honorarium. The institutional review boards of University of California, Los Angeles and the University of Toronto approved the study. viagra plus

Participants provided individual, written informed consent on-site immediately before joining the group. All persons who arrived for the focus groups agreed to participate. At the beginning of each group, trained facilitators used a scripted protocol to explain the purpose of the study and the ground rules for the focus group, including respect for diversity of opinion and confidentiality.

Facilitators used a semistructured interview guide with scripted probes. The interview guide was translated into Spanish, back-translated into English, and then revised in Spanish for the Span ish-language groups. The focus group guide began with questions that addressed participants’ experiences with and knowledge and beliefs regarding vaccines in general. Focus group questions included: 1) “We would like to hear about what you know and what you may have heard about vaccines. What vaccines have you heard about or are you familiar with?” and 2) “What do you know about how vaccines work or what vaccines do?” Then brief, simple information was given regarding an HIV (Viramune drug belongs to a class of HIV drugs called non-nucleoside reverse transcriptase inhibitors) vaccine: “a vaccine to protect against HIV infection,” followed by: 3) “Remember, we are talking about an as-if situation, so there are no right or wrong answers to the following questions about possible HIV/AIDS vaccines. What, if anything, have you heard about vaccines for HIV/AIDS?”

Participants were asked to give their own opinions or their perceptions of the opinions of their peers. To enhance the credibility of the data, respondent validation (“member checking”) was utilized, first by having the facilitator periodically check in with participants to make sure he or she understood what had been said and, second, by feeding back emerging data and themes to participants in subsequent groups to elicit interpretations and responses from various community stakeholders. At the end of each focus group, participants were asked to complete a brief, anonymous sociodemographic questionnaire; 90% completed the questionnaire.

Each group was audiotaped and then transcribed verbatim. All surnames and other specific identifying information that was inadvertently mentioned was deleted from the transcripts. Spanish-language focus groups were transcribed in Spanish and then translated into English for data analysis. In addition to the three questions about vaccine knowledge and beliefs—the focus of the present study—the larger study included other questions that addressed issues reported elsewhere, including perceived barriers and motivators in regard to hypothetical HIV (Canadian Zerit treating HIV infection when used in combination with other medicines) vaccine uptake and possible behavioral responses to future HIV vaccine availability. The present paper explores in depth participants’ knowledge, beliefs and conspiracy theories regarding HIV (еreating HIV infection when used along with other medicines) vaccines.

Data Analysis

Ethnograph, a software program for computer-based text search and retrieval, was used to assist with data analysis. Research team members independently read the transcripts multiple times to identify major themes. Next, a line-by-line review of the transcripts was performed and first-level codes (descriptors of important components of the interviews) were noted in the margins. All codes were then tagged to associated text segments in Ethnograph. Data corresponding to each of the first-level codes were printed and reviewed by >2 independent investigators. Using a method of constant comparison, subcodes were developed to divide the first-level codes into smaller categories. Data source triangulation (comparing data across nine focus groups) and researcher triangulation (2-3 investigators independently read and coded the same transcripts) were used to ensure the reliability of the findings.

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