Community Preparedness for HIV Vaccine Trials in the Democratic Republic of Congo
HIV and AIDS is a common disease in Africa and different methods to combat them have been implemented throughout the years. An effective HIV vaccine is sought after all countries; in the Congo, the UNAIDS estimated that there were more than one million people living with AIDS/HIV. The main means of transference is through sexual contact between heterosexual adults.
There have been no ongoing clinical trials in the Congo to battle against the virus. Between October 2003 and March 2004, scholars undertook in-depth interviews and focus groups in capital, Kinshasa, under the auspices of the National AIDS Control Program (PNLS) to see what the community preparedness for HIV vaccine trials was like.
The interviewees were divided into two groups and underwent 27 interviews. “Group A consisted of fifteen HIV-1 seronegative persons at high-risk for HIV infection, characteristics which make them potential candidates for an HIV vaccine clinical trial. Seven were men, eight were women (all of the women identified themselves as sex workers). Group A was composed of participants with primary, secondary, or university level education who had access to AIDS information and counselling … In Group B, we enrolled 12 persons who were leaders in the health, educational, religious, legal, security, or civic spheres, and were not required to have prior HIV test results. In total, 27 in-depth interviews with 12 men and 15 women were conducted, all of whom were at least 18 years old. Interview questioning was open-ended, with interviews averaging about 45 minutes in length”.
11 men and nine women were interviewed in two focus groups, each consisting of 10 people. Testing for HIV was not performed for this focus group but participants were HIV positive. One focus group approached the topic of a VIV vaccine; the other group talked about sexual behaviour and personal AIDS narratives.
These three groups were all told that “a hypothetical HIV vaccine would first be introduced as clinical trials of safety and efficacy”. The interviews were all conducted in either French or the local language, Lingala. Oral consent was used, each contract being read aloud, as participants were mostly illiterate and were given $5 each for the two interview group and $2 for the focus groups each as travel compensation.
Group A had knowledge of several HIV vaccines and how a vaccine prevents a disease. One divorced sex worker (female) stated about her knowledge of HIV and how clinical trials were conducted: “I know something about vaccines, for example, measles, TB, and the polio vaccine all these I have given to children. This is done when a child is born, and every time a child is taken to a medical unit for check-up he is given drops or injections. As far as I’m concerned, after the [HIV] vaccine is tested on animals, there is no problem for it to be given to human beings, even if it is during the experimental period. I am a candidate”.
Group B presented their own experiences regarding vaccines, AIDS in general and clinical trials. One participant said this about some locals’ views on AIDS and HIV: “First of all, some people think AIDS does not exist. Second, some others think that it is caused by demons. Some others believe that it is a disease caused by sorcery. Some others say that White people have brought it to kill all people in our country so that they can come and dominate us”.
Group C’s response to sexual behaviour and experience of HIV and AIDS were most related to their own personal experiences. A student health clinical physician told the interviewers about the ‘chic, choc, cheque’ phenomenon: “A girl, a student, has three types of partners. She has her ‘chic’, whom she calls her fiancé, and whom she plans to marry. And then a ‘choc’, who might be a classmate, or a professor, who is the person who helps her pass her classes, to take notes for her, to take exams for her, or if a professor, to fudge her grades, or do favours such as getting a grade or passing classes in exchange for sex. Also, the ‘cheque’, the person who takes care of the girl’s needs, who gives her money to survive, pays her fees so that she has enough to eat on the campus. All these are risk behaviours”.
From the information given from Group C, it was clear that talk of sex on campus, and throughout the rest of the Congolese society, was strictly taboo and even went so far as to deny the disease itself.
The interviews that were conducted produced some interesting results. It showed that the people who understood the disease were hopeful that vaccines could be produced and trailed in the Congo. But it was also clear that gaining the trust of the people was to be crucial in furthering a vaccine for the disease.
Olin, John., & Kokolamami, Jacques., Lepira, B. Francois., Mwandagalirwa, Kashamuka., Mupenda, Bavon., Ndongala, Michel Lubaki., Maman, Susan., Bollinger, Robert., Nachega, Jean & Mokili, John (2006) Community Preparedness for HIV Vaccine Trials in the Democratic Republic of Congo, Culture, Health & Sexuality, Taylor & Francis, Ltd.