Document text
Principal Investigator: Alison Meredith Buttenheim
Organization: UNIVERSITY OF PENNSYLVANIA
Fiscal Year: 2024
Award: $583,238
Funding agency: National Institute of Mental Health
PROJECT SUMMARY
A safe, effective, affordable and acceptable vaccine against HIV has been an epidemic-ending goal for decades,
and recent years have seen substantial progress towards developing and testing promising candidate vaccines.
For highly vulnerable groups like adolescent girls and young women (AGYW) in sub-Saharan Africa, access and
uptake of vaccines will be essential for reducing the exceptionally high HIV incidence observed in recent years.
This is particularly true in South Africa, which has the world's largest HIV epidemic and several active HIV vaccine
trial programs. While an HIV vaccine has the potential to substantially reduce HIV risk, realizing this potential will
require widespread vaccine uptake. Unfortunately, the lived experiences of both the HIV epidemic and the
ongoing COVID-19 pandemic have laid the groundwork for an infodemic of misinformation about the HIV
vaccine. Likely attributes of the HIV vaccine (e.g., partial protection against HIV), low trust in governmental and
medical research institutions, and poor understanding of how vaccines work will leave an HIV vaccine program
vulnerable to misinformation among the populations who would most benefit from vaccine-induced protection.
To realize the benefits of future HIV vaccines, novel communication strategies are needed to “inoculate”
individuals at highest risk of HIV infection against contagious vaccine misinformation. In this study, we bring
together two promising approaches – psychological inoculation theory and behavioral economics – to fight HIV
vaccine misinformation. Psychological inoculation theory offers a compelling approach to building “resistance”
to vaccine misinformation through explicit exposure to a “weakened” version (via direct refutation) of false
arguments underlying misinformation, before stronger versions of misinformation are encountered. Importantly,
by
posits
debunking
prebunking (or pre-emptively warning individuals about) emerging misinformation, inoculation theory also
that t hey will be better able to r esist future misinformation. Prebunking avoids the greater challenge of
once misinformation has lodged. In addition, behavioral economics provides a complementary
framework that recognize the cognitive and attentional constraints faced by individuals and can inform more
effective inoculation messages. We propose a randomized controlled trial of inoculation messages with a
behavioral economics “boost” with AGYW in South Africa, a population highly vulnerable to both HIV infection
and to vaccine misinformation. Mirroring a vaccine trial, our behavioral trial will evaluate the efficacy, safety,
durability, and generalized immunity effects of inoculation messages that are boosted with behavioral economics
insights. We will also evaluate differential responses to the messages by important subgroups of AGYW. This
proof--of-concept project has the potential to identify innovative communication strategies to build resistance to
emerging and evolving HIV vaccine misinformation. Results from the study will advance the science of HIV
vaccine demand creation and inoculation-theory based approaches to vaccine communication.
Terms: <2 arm RCT><2 arm randomized control trial><2 arm randomized controlled trial><2019-nCoV vaccine><AIDS Virus><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Active Follow-up><Africa South of the Sahara><Attention><Behavioral><Behavioral trial><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 vaccine><COVID-19 years><Characteristics><Cognitive><Communication><Complement><Complement Proteins><Contracting Opportunities><Contracts><Decision Making><Epidemic><Exposure to><Female Adolescents><Future><Goals><HIV><HIV Infections><HIV risk><HIV vaccine><HIV/AIDS Vaccines><HTLV-III Infections><HTLV-III-LAV Infections><Hearing><History><Human Immunodeficiency Viruses><Human T-Lymphotropic Virus Type III Infections><Immunity><Incidence><Individual><Institution><LAV-HTLV-III><Lived experience><Lived experiences><Lymphadenopathy-Associated Virus><Medical Research><Misinformation><Pattern><Population><PrEP><Province><Randomized, Controlled Trials><Recording of previous events><Reporting><Resistance><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-CoV-2 vaccine><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><SARS-coronavirus-2 vaccine><Safety><Science><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe Acute Respiratory Syndrome CoV 2 vaccine><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Severe acute respiratory syndrome coronavirus 2 vaccine><South Africa><Sub-Saharan Africa><Subgroup><Subsaharan Africa><Survey Instrument><Surveys><Testing><Time><Trust><Vaccination><Vaccination acquired immunity><Vaccination induced immunity><Vaccines><Virus-HIV><Visit><Vulnerable Populations><Work><accept vaccination><accept vaccine><active followup><adolescent girl><aged><behavioral economics><complementation><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease 2019 vaccine><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><coronavirus disease-19 vaccine><design><designing><determine efficacy><efficacy analysis><efficacy assessment><efficacy determination><efficacy evaluation><efficacy examination><evaluate efficacy><examine efficacy><fighting><follow up><follow-up><followed up><followup><hesitant to vaccination><heuristics><high risk><histories><human immunodeficiency virus vaccine><infodemic><innovate><innovation><innovative><insight><interest><life-time risk><lifetime risk><nCoV vaccine><nCoV-19 vaccine><nCoV19 vaccine><novel><pre-exposure prophylaxis><programs><psychologic><psychological><randomized control trial><recruit><resistant><response><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><theories><two arm RCT><two arm randomized control trial><two arm randomized controlled trial><vaccination acceptability><vaccination acceptance><vaccination confidence><vaccination hesitancy><vaccination study><vaccination trial><vaccination uptake><vaccination willingness><vaccine acceptability><vaccine acceptance><vaccine acquired immunity><vaccine against 2019-nCov><vaccine against COVID-19><vaccine against SARS-CoV-2><vaccine against SARS-coronavirus-2><vaccine against Severe Acute Respiratory Syndrome CoV 2><vaccine against Severe acute respiratory syndrome coronavirus 2><vaccine associated immunity><vaccine candidate><vaccine candidates against SARS-CoV-2><vaccine confidence><vaccine for novel coronavirus><vaccine hesitancy><vaccine hesitant><vaccine study><vaccine trial><vaccine uptake><vaccine willingness><vaccine-induced immunity><vaccine-induced protection><vaccines preventing COVID><vaccines to prevent COVID><vulnerable group><vulnerable individual><vulnerable people><willingness><young woman>