The role of culture-centered community engagement in HIV vaccine research

Abstract

For decades, the toll of HIV/AIDS has devastated communities worldwide. HIV counseling and testing, as well as other evidence-based behavioral interventions, are available in many communities, but these measures alone have been unsuccessful in preventing the spread of HIV. A safe, effective, and acceptable method of HIV prevention is therefore necessary to decrease transmission. HIV vaccine research necessitates the involvement of diverse populations to ensure social justice aims of the effort are fulfilled, to maintain scientific integrity, and to claim generalizability of study findings. Therefore, cultivating relationships with local communities are critical to the success of HIV vaccine research. These issues are of particular concern for minority populations who have been underrepresented in HIV vaccine studies and where research suspicion has been a significant barrier. This study examines the role of a HIV vaccine community engagement model in the attainment of three primary goals: future attendance, community mobilization, and study volunteerism. The Theory of Reasoned Action (TRA), inclusive of consumer-oriented variables, was identified to understand the pathways of influence on participatory decision-making. To this end, a pilot sample of 212 participants, mostly female and non-White, was conducted for purpose of achieving strong internal subscale consistencies for structural equation modeling. A subsequent study (N =542) was also conducted in the field setting with a similar population to retest the instrument’s psychometric measures, and for the purpose of confirmatory factor analyses and model testing. The findings indicate that the TRA "background variables" of behavioral and normative beliefs, along with motivation to comply, exhibited significant effects on endogenous variables, subjective norms and attitudes. Attitudes towards the three behavioral intentions was the most significant and consistent determinant among models. External variables of personal relevance and organizational involvement also had significant mediating, and direct, influences on the outcomes. However, the effects of these differed with respect to each of the participation considerations. These factors suggest the community participatory model of HIV vaccine promotion has encouraged collective engagement in the cause via messages focused on the value of health research, the personal relevance of volunteerism, and the salience of the clinical organization in the endeavor.