Planned clinical trials revive hope that an HIV vaccine can be found

SBR is the study of human behaviour and social systems. [Sammy Omingo, Standard]

After four decades of tireless research, groundbreaking developments in HIV vaccine research are offering new hope to scientists and the global health community alike. An effective HIV vaccine would prevent new HIV infections and could therefore play a powerful role in bringing the Aids epidemic to an end.

While the HIV vaccine journey seems to have taken long, research done to date has yielded fruits in the development of a Covid-19 vaccine and paved the way for innovations that bring the field closer to an HIV vaccine.  

Nonetheless, the enthusiasm about the new discoveries is sometimes cast in the shadow of the decades of research and sometimes disappointing results. So how can researchers nurture a participant-centred approach in this search for a vaccine to prevent HIV? How do you employ cutting-edge science to accelerate the search for a vaccine, while still guaranteeing that the population you seek to benefit from this research will have access to and will take up the resulting products?

While new models for delivery of HIV prevention are undoubtedly essential, the need for participant-centred programming cannot be over-emphasised. So is the need for research that increases cultural relevance and enhances applicability and use of efficacious HIV prevention strategies.

One way to achieve this is by incorporating socio-behavioural research (SBR) within HIV prevention programmes and clinical research. By so doing, we create an opportunity to recognise communities for their agency role rather than the assumed role of being passive beneficiaries or merely research participants.

SBR is the study of human behaviour and social systems. It measures, describes, explains, and predicts changes in social and economic structures, attitudes, values, and behaviours and the factors which motivate and demotivate individuals and groups in society. In the health sector, SBR explores how these factors might impact health outcomes. 

In 2021, findings from the Phase I clinical trial (International AIDS Vaccine Initiative) IAVI G001 showed that vaccines can be designed to stimulate rare immune cells with specific properties to fight a wide range of HIV strains.

The study showed that, in 97 per cent of the participants, vaccination with a HIV immunogen known as eOD-GT8 60mer, safely induced the targeted immune responses that generate antibodies against the fast-mutating virus.

A build up to the IAVI G001 study is an IAVI-sponsored trial in Africa known as IAVI G003. IAVI G003 is designed to test the hypothesis that vaccination with eOD-GT8 60mer, can induce the same targeted immune responses in African populations. The data from IAVI G003 will be important in guiding this approach of vaccine development, especially in the continent most affected by HIV.

Beyond the clinical component of the IAVI G003 trial, the study will employ SBR to seek an understanding of the acceptability of the sampling techniques used in the trial. Since these sampling techniques are not usually encountered in clinical care or clinical trials within the African context, it will be crucial for participants to understand the procedures and the impact of the procedures in themselves and their communities more broadly.

These techniques include a procedure in which a thin, hollow needle is inserted into the lymph node to extract specific cells for examination (fine needle aspiration) and one in which blood is passed through a machine to take out the white blood cells and return all the other blood cells and plasma back into the bloodstream (leukapheresis).

To those conducting the trial, SBR will help in understanding the acceptability of these procedures, as well as their impact on recruitment and retention of participants onto studies employing these techniques.

We anticipate that the findings will support the development of interventions that manage participant concerns on sampling techniques in future clinical trials, improve the clinical trial experience, recruitment and retention and ultimately support HIV vaccine clinical trial implementation.

As we recognise the many volunteers, community members, health professionals, and scientists who are working together to find a safe and effective vaccine to prevent HIV, it is important to recognise the substantial opportunity to improve participation of volunteers through SBR.

We also recognise that with SBR, there’s a great potential to ensure a more sustainable response with everyone actively participating in their own care and meaningfully contributing to the production of knowledge on HIV prevention.

This way, we shall tap into the resourcefulness, resilience and knowledge of the participants and their communities, to strengthen research and programmes, making them more relevant, appropriate and effective. Indeed, a HIV vaccine is achievable; a vaccine developed together with the people it seeks to benefit most.