Will HIV Vaccine Advances Become Mired in Ethics and Risk-Group Refusals?

As recent medical breakthroughs propel the discovery of HIV vaccines into the realm of near future possibilities, AIDS statistics identify high-risk groups. Yet, will those engaging in risky behavior opt to receive an HIV vaccine? And what about ethics?

Scientists Discover HIV Antibodies

The much-awaited press release from the National Institute of Allergy and Infectious Diseases (NIAID) reveals that scientists have isolated human antibodies which - in the Petri dish laboratory environment - succeeded at preventing the infection of human cells with more than 90 percent of HIV strains.

Best off all, by being able to break down the process step-by-step, HIV vaccine research has taken a gigantic leap forward, since this points to a process that may be duplicated at will. Not surprisingly, Dr. Peter D. Kwong goes on record and states that "the discoveries we have made may overcome the limitations that have long stymied antibody-based HIV vaccine design."

HIV Vaccine Research and Its Ethical Implications

Of course, the devil is in the details, and the fact that the HIV vaccine trials have resulted in 90 percent effectiveness leaves a 10 percent failure rate to contend with. How does one test a vaccine that is designed to prevent the onset of a fatal disease in humans, when 10 percent of test subjects are likely to remain unprotected?

Citing alarming AIDS statistics, the Public Library of Science outlines that (worldwide) each year sees 5 million new HIV infections, as well as 3 million AIDS deaths. At this time, the emphasis on HIV vaccine research focuses on the African continent, and the barriers to participation - for women - are culturally held beliefs and practices. Although touching on the issue of informed consent, study advisors fail to explain how to encourage HIV vaccine trial participation in light of the likely failure rate.

Of course, it is easy to assert that some high-risk groups will continue to engage in risky behavior - either voluntarily (as in the West) or involuntarily, as is the case in some African communities - and, therefore, make good test subjects. This reasoning goes along the lines of explaining "collateral damage" as being acceptable.

From H1N1 Vaccine Fiasco to HIV Vaccine Refusal?

Loyal readers may remember the CDC nationwide recall of 800,000 kids' swine flu vaccine doses in December of 2009, and the general sense of distrust that the H1N1 vaccine engendered in the American public. With the mischaracterization of the swine flu as a global epidemic and the resulting vaccine shortage, it stands to reason that HIV vaccine research that only produces a partially effective immunization could also meet with resistance.

In fact, a February 2010 news release from the UCLA newsroom shows that study participants who were asked about their feelings with respect to an HIV vaccine were only "moderately accepting." It is worthwhile to point out that study participants consisted of Los Angeles County patients who sought out STD clinics, Hispanic primary healthcare centers and also needle-exchange venues.

Add to this that 10 percent of surveyed adults revealed that they would participate in more risky behavior if vaccinated - if the vaccine was more than 50 percent effective - and it stands to reason that any HIV vaccine is sure to become mired in ethics considerations and also target-group resistance.

Sources

⁽¹⁾http://www.niaid.nih.gov/news/newsreleases/2010/Pages/HIVantibodies.aspx

⁽²⁾http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0030094

⁽³⁾http://newsroom.ucla.edu/portal/ucla/high-risk-populations-may-not-151144.aspx