Enrolling Women into HIV Preventive Vaccine Trials An Ethical Imperative but a Logistical Challenge 英文参考文献.docVIP

loicPy Forum Enrolling Women into HIV Preventive Vaccine Trials: An Ethical Imperative but a Logistical Challenge Edward Mills, Stephanie Nixon, Sonal Singh, Sonam Dolma, Anjali Nayyar, Sushma Kapoor* W ith almost 5 million new HIV infections and 3 million deaths from AIDS occurring represents an important challenge that must be ful?lled in order to conduct ethical, valid, and generalizable trials [3–5]. may be burdened with childcare and a lack of transportation. For women with children, participation is often limited by having to attend one of the few trial sites that offer childcare [6]. Indeed, trials requiring that pregnancy and breast-feeding be avoided may place undue stress upon participants in cultures that place value on women’s fertility. Some cultural barriers identi?ed in the recent HIV vaccine candidate trial in Kenya included women’s belief that a woman of childbearing age who uses contraceptives is giving her husband an excuse to look for another woman with whom to bear children [7]. On the other hand, men believed that childbearing was a way of keeping every year worldwide, the development of a safe, effective, and accessible HIV vaccine has become one of the most urgent global public health needs. The United Nations estimates that 17.5 million women between the ages of 15 and 49 years are living with HIV, accounting for nearly half of the 40.3 million infections worldwide [1]. These ?gures reveal the increasingly female face of AIDS. Women’s Concerns about Enrolling in HIV Vaccine Trials Efforts to enroll and retain women in trials begin by recognizing that their expectations and requirements for participation may be different from those of men. Women may lack the decision-making freedom to participate in a trial, especially a trial that addresses sexual behavior. They As with many diseases, women in developing countries are particularly vulnerable to HIV. Poverty—and women’s necessary reliance on men for economic subsistence—may force some women