The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62492

Robert L. Hood, PhD, Department of Philosophy, Middle Tennessee State University / St. Thomas Hospital, Box 73, Murfreesboro, TN 37132, 6158982050, rhood@mtsu.edu

The paper focuses on ethical issues in HIV vaccines research and future HIV vaccines. Multiple HIV vaccines are in development; one is in the process of wide-scale human testing. Since early vaccine-candidates will likely be only minimally-efficacious (perhaps 30% effective), studies will need to involve large numbers of people in order to demonstrate whether the vaccines are effective. The only way to to gauge the effectiveness of early HIV vaccines will be to compare thousands of people who receive them with thousands who do not. Only trials among groups with high infection rates will provide the necessary data to determine whether the vaccine candidate is effective. In practice, this means tens or hundreds of thousands of people will need to be enrolled in trials. The main focus is on ethical problems arising from the likelihood that individuals will alter their behavior if they believe an HIV vaccine candidate or a future HIV vaccine -- even a minimally-efficacious one-- will give them some protection from HIV infection. The paper explores approaches to weighing tradeoffs between research and the need to protect individuals, given the likelihood that some people will alter their behavior toward more risky behavior given their belief that a vaccine is efficacious. The paper draws on discussions of the Ethics Working Group of the HIV Vaccine Trials Network concerning the ethical need for education and community involvement programs to minimize the risks that people will engage in riskier behavior in the presence of a minimally-efficacious HIV vaccine.

Learning Objectives:

• At the conclusion of the session, the participant (learner) in this session will be able to:
• Describe 3 central ethical issues posed by HIV vaccines, in particular those posed by a minimally-efficacious vaccine (a vaccine that is at least 30% effective).
• Analyze approaches to weighing trade-offs between the need for research and the risks posed to individuals who may alter their behavior given their belief in the efficacy of a trial vaccine, or a future minimally-efficacious vaccine.
• Incorporate the ethical analysis into a systematic clinical response to the problem of behavioral change given beliefs about the efficacy of HIV vaccines

Keywords: Ethics, HIV/AIDS

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: HIV Vaccine Trials Network
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.