HIV vaccine acceptability: a systematic review and meta-analysis

Objective: To conduct a systematic review of the literature to examine HIV vaccine acceptability and factors impacting acceptability of future HIV vaccines. Design: Systematic review and meta-analysis of peer-reviewed articles that assessed HIV vaccine acceptability. Methods: We used a comprehensive search strategy across multiple electronic databases to locate original quantitative or qualitative studies that examined rates or correlates of HIV vaccine acceptability. We conducted meta-analysis on studies reporting correlates or predictors of HIV vaccine acceptability. Results: Twenty studies (n=7576) reported HIV vaccine acceptability ranging from 37.2 to 94.0 on a 100-point scale; weighted mean acceptability=65.6 (SD=21.1). Eleven studies compared HIV vaccine acceptability at high (80-95%) efficacy (mean=73.8; SD=9.2) versus moderate (50%) efficacy (mean=40.4; SD=20.2). Among 13 studies (n=5023) included in meta-analysis, efficacy and non'risk group' membership had medium effect sizes, and pragmatic obstacles, cost, perceived susceptibility to HIV infection, side effects/safety concerns, fear of vaccines, perceived vaccine benefits, duration of protection, and ethnicity had small effect sizes on HIV vaccine acceptability. Conclusion: Public health strategies to promote the benefits of partial efficacy HIV vaccines and accurate HIV risk perceptions, and to dispel vaccine fears, along with structural interventions to subsidize vaccine costs and facilitate access, may increase future HIV vaccine uptake and, in turn, the effectiveness of HIV vaccines in controlling the epidemic. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins