Tracey-Ann Wisdom, Gleaner Writer
( L - R ) Duncan , Figueroa
Jamaica has been involved in HIV-vaccine research for the past three years.
Since 2005, the Epidemiology Research and Training Unit (ERTU) on Slipe Pen Road in Kingston has recruited volunteers for two vaccine trials. The first trials began in August 2006, and involved 32 volunteers. Two more trials are currently under way, one with 11 participants and the other with 24. These are part of a global network, HIV Vaccine Trials Network (HVTN), which operates out of the United States and has sites in that country as well as in parts of Africa, Europe, South America and the Caribbean.
The ERTU has consistently met its recruitment targets and Joy Braham, coordinator of the study, says people have been receptive to the idea of an HIV vaccine. However, The Gleaner has found that some people are sceptical about the vaccine and quite a few have never even heard about the trials.
"One vaccine fi HIV? No, mi no know nothing bout dat at all," said a young mother with whom The Gleaner spoke in Half-Way Tree, St. Andrew.
However, Braham pointed out that the ERTU and the Ministry of Health have been working to sensitise the public to the vaccine.
"Dr. Peter Figueroa (principal investigator for the trials) has been interviewed on electronic media. We have several different groups working with. There were posters in clinics and presentations to pharmacists, even though most of them didn't attend," she said. "Dr. Figueroa did presentations with university students. Articles have been written, including a series in The Gleaner. Maybe we need to go much wider in terms of targeting certain groups."
Among the persons who know about the vaccine, most of the people who spoke to The Gleaner said they hope it works, but they would rather not volunteer for a trial.
"To me, HIV is a man-made thing and I feel they have the antidote for it. Like other diseases like polio, they developed vaccine that cure or help it, so yes, it should work," said Linval Officer, a 67-year-old vendor in Half-Way Tree.
"Any study is welcome, even though preliminary studies found that it (vaccine) is not effective," said a Spanish Town-based doctor who requested anonymity. "Hopefully, something good will come out of it and the benefits outweigh the risks."
Safety concerns
He said he would be willing to participate in a trial if he had the time, but expressed concerns about the safety of the vaccine.
"As with all vaccines, some people do become infected," he said. "I know they just use certain sections of the HIV, but viruses are unpredictable."
Dr. Jacqueline Duncan, co-principal investigator for the trials, acknowledged that "there will always be sceptics", but clarified that there is no actual HIV in the vaccine, which consists of synthetic protein made to look like the virus. "HIV itself has genetic matter - nine proteins and enzymes," she said. "What they've done is make a replica of one of these proteins. It is not made of HIV, whether live or killed."
Dr. Figueroa admitted that the idea of an HIV vaccine is "complicated to explain", and sought to simplify the process of creating the vaccine by likening it to how a sculpture of a face is made: the artist makes a clay model of the subject's face, then casts it. The artist then uses the material he wishes to make the sculpture from to cover the model, he said, adding that a similar process of creating an artificial model is used when making the HIV vaccine.
Both Miss Braham and Dr. Duncan agreed that there are members of the health care profession who do not know exactly how the vaccine works.
"We have been informing different health groups," Miss Braham stated. "We find that the more information they have, the more receptive they are."
Unfamiliar with facts
Dr. Figueroa also said many doctors are not familiar with the basic facts of the vaccine trials and that they should liken the vaccine to similar ones that have eliminated polio, rubella and diphtheria, among other chronic diseases.
"You would think they would use the analogy of childhood vaccines that have transformed child health care. If they would just make the analogy, they would see the value of a preventive HIV vaccine," he said.
Dr. Figueroa also pointed out that the lack of knowledge and subsequent negative attitude towards the vaccine is a "big challenge" to the trials. "What you find is that there is a lot of stigma to anything with HIV," he said. "People react emotionally. When I'm explaining to different groups, there are individuals who say they are not interested, but in every group, I've found that there are people who are quite open to participating in the trials and learning more about the vaccine."
The International AIDS Vaccine Initiative (IAVI) website - www.iavi.org - which Dr. Figueroa recommends to anyone seeking information on HIV vaccine development, states: "Even partially effective vaccines could make a difference by protecting some vaccinated individuals against HIV infection; reducing the probability that a vaccinated individual who later becomes infected will transmit the infection to others; or slowing the rate of progression to AIDS for those who later become infected with HIV."
Dr. Duncan believes the HIV vaccine trials are important because, over the years, the behaviour change necessary to stop the spread of HIV has not occurred, so a vaccine could have the greatest impact on HIV prevention. Statistics from the Ministry of Health show that, in 2004, HIV/AIDS was the leading cause of death for both young men and women aged 15-24 years old in Jamaica, and was a leading cause of death among Jamaica's children as well. There are over 500 children living with HIV, most of them born to HIV-positive mothers. It is also estimated that 25,000 Jamaicans are living with HIV and, since 1982, a total of 6,437 AIDS cases have been reported.
