Motivations to participate in a Phase I/II HIV vaccine trial: A descriptive study from Dar es Salaam, Tanzania.

BACKGROUND: The search for an efficacious HIV vaccine is a global priority. To date only one HIV vaccine trial (RV144) has shown modest efficacy in a phase III trial. With existing different HIV-1 subtypes and frequent mutations, multiple trials are needed from different geographical sites particularly in sub-Saharan Africa where most HIV infections occur. Thus, motivations to participate in HIV vaccine trials among Tanzanians need to be assessed. This paper describes the motives of Police Officers who showed great interest to volunteer in HIVIS-03 in Dar es Salaam, Tanzania. METHODS: A descriptive cross-sectional study was conducted among Police Officers who showed interest to participate in the HIVIS-03, a phase I/II HIV vaccine trial in Dar es Salaam. Prior to detailed training sessions about HIV vaccine trials, the potential participants narrated their individual motives to participate in the trial on a piece of paper. Descriptive analysis using content approach and frequency distributions were performed. RESULTS: Of the 265 respondents, 242 (91.3%) provided their socio-demographic characteristics as well as reasons that would make them take part in the proposed trial. Majority, (39.7%), cited altruism as the main motive. Women were more likely to volunteer due to altruism compared to men (P < 0.01). Researchers' explanations about HIV/AIDS vaccine studies motivated 15.3%. More men (19.6%) than women (1.7%) were motivated to volunteer due to researchers' explanations (P < 0.001). Also, compared to other groups, those unmarried and educated up to secondary level of education were motivated to volunteer due to researchers' explanation (P < 0.05). Other reasons were: desire to become a role model (18.6%); to get knowledge for educating others (14.0%); to cooperate with researchers in developing an HIV vaccine (9.5%); to get protection against HIV infection (7.0%), and severity of the disease within families (6.2%). These results were supported by testimonies from both men and women. CONCLUSIONS: Participation in an HIV vaccine trial in a Tanzanian context is likely to be influenced by altruism and comprehensive education about the trial. Gender differences, marital status and education level need to be considered to enhance participation in future HIV vaccine trials.

Measuring HIV Stigma for PLHAs and Nurses Over Time in Five African Countries

The aim of this article is to document the levels of HIV stigma reported by persons living with HIV infections and nurses in Lesotho; Malawi; South Africa; Swaziland and Tanzania over a 1-year period. HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection; their adherence to medication; and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection. This study used standardised scales to measure the level of HIV stigma over time. A repeated measures cohort design was used to follow persons living with HIV infection and nurses involved in their care from five countries over a 1-year period in a three-wave longitudinal design. The average age of people living with HIV/AIDS (PLHAs) (N=948) was 36.15 years (SD=8.69); and 67.1(N=617) were female. The average age of nurses (N=887) was 38.44 years (SD=9.63); and 88.6(N=784) were females. Eighty-four per cent PLHAs reported one or more HIV-stigma events at baseline. This declined; but was still significant 1 year later; when 64.9reported experiencing at least one HIV-stigma event. At baseline; 80.3of the nurses reported experiencing one or more HIV-stigma events and this increased to 83.71 year later. The study documented high levels of HIV stigma as reported by both PLHAs and nurses in all five of these African countries. These results have implications for stigma reduction interventions; particularly focused at healthcare providers who experience HIV stigma by association

The knowledge, attitudes and perceived support of Tanzanian nurses when caring for patients with AIDS.

In the literature on AIDS, much attention has been paid to the Western health care workers' knowledge of and attitudes toward AIDS. Little is known of the knowledge and attitudes of health care workers of developing countries. This study provides a descriptive and comparative examination of Tanzanian nurses' knowledge of, and attitudes towards AIDS and their perceived support when caring for patients with AIDS. A self-completing questionnaire was used to collect data. Questionnaires were completed and returned by 172 of the 180 nurses to whom they were distributed, a response rate of 95.5%. A random sample of 45 nurses was chosen from each hospital--two teaching and two regional hospitals. Data analysis included descriptive statistics, t-test, correlation coefficient, ANOVA and multiple regression. The research revealed that 96% of Tanzanian nurses appeared to have a satisfactory or passing level of knowledge about AIDS. However, they are overly cautious and have negative attitudes toward the care of patients with HIV/AIDS. They lacked knowledge regarding transmission and risk factors and indicated fear of contagion (AIDS-phobia). Most nurses indicated that they had a supportive working environment (informal support groups) in their working areas, but few formal supports and little in-service education. Further, they received support from their family and friends.

PIP: Nurses play a major role in caring for people with AIDS. As such, the authors descriptively and comparatively appraise a sample of Tanzanian nurses' knowledge of and attitudes toward AIDS, as well as their perceived support when caring for people with AIDS (PWA). The investigative is based upon responses to questions received from 172 randomly-sampled nurses drawn from two teaching and two regional hospitals. More than 80% of the respondents were female, 70.9% were married, and half were aged 36 years and older. 58% had more than 10 years experience in nursing, almost 90% had 2-10 years experience caring for HIV-infected individuals, and 49% worked in the medical wards. Even though many were misinformed or uninformed about the lack of infection risk from casual contact with PWAs, contact with tears, and contact with saliva, the authors found 96% of the nurses to be satisfactorily knowledgeable about AIDS. The nurses treated PWAs with too much caution and negatively despite their experience. Most reported having supportive and little in-service education. Family and friend support was also received. The author's stress the need to educate and sensitive nurses in Tanzania to provide the highest level of care possible to PWAs.