Abstract
Compulsory vaccination is a frequently implemented policy option for ensuring comprehensive vaccine coverage. Ongoing controversies around human papillomavirus vaccine dissemination, and suboptimal coverage, suggest the value of assessing acceptability of compulsory vaccinations—particularly among likely target populations—in advance of their public availability to support evidence-informed interventions. With the first HIV vaccine to demonstrate partial efficacy in a large-scale clinical trial, we examined individual characteristics and attitudes associated with support for compulsory HIV vaccination policy among a diverse, representative sample of adults attending probable HIV vaccine dissemination venues in a large urban county. Participants were recruited using three-stage probability sampling from likely venues for future HIV vaccine dissemination. We used Audio-CASI to administer a 60-min structured questionnaire. Items included endorsement of compulsory HIV vaccination policy, sociodemographic characteristics, injecting drug use, vaccine attitudes and perceived HIV risk. Among 1,225 participants (mean age = 36.8 years; 55.6 % males, 37.6 % non-English speaking Hispanic, 78.8 % heterosexual, 25.7 % injection drug users), almost half (48.2 %) endorsed a compulsory HIV vaccination policy. Non-English speaking Hispanics compared to whites, participants with less than high school education, higher positive vaccine attitude scores and higher perceived HIV risk were significantly more likely, and people who inject drugs significantly less likely to endorse compulsory HIV vaccination. Public health interventions to promote positive vaccine attitudes and accurate perceptions of HIV risk among vulnerable populations, and strategies tailored for people who inject drugs, may build support for compulsory HIV vaccination policy and promote broad HIV vaccine coverage.
Similar content being viewed by others
References
Bearman, P. (2010). Just-so stories: Vaccines, autism, and the single-bullet disorder. Social Science Quarterly, 73, 112–115.
Centers for Disease Control and Prevention. (1998). Effectiveness of a seventh grade school entry vaccination requirement—statewide and Orange County, Florida, 1997–1998. Morbidity and Mortality Weekly Report, 47, 711–715. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/00054618.htm.
Centers for Disease Control and Prevention. (1999). Ten great public health achievements—United States, 1900–1999. Morbidity and Mortality Weekly Report, 48, 241–243. Retrieved from www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm.
Centers for Disease Control and Prevention. (2002a). Unrecognized HIV infection, risk behaviors, and perceptions of risk among young black man who have sex with men—six U.S. cities, 1994—1998. Morbidity and Mortality Weekly Report, 51, 733–736. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5133a1.htm.
Centers for Disease Control and Prevention. (2002b). Substance abuse treatment and public health: Working together to benefit injection drug users. Retrieved from www.cdc.gov/idu/facts/workingtogetherFin.pdf.
Centers for Disease Control and Prevention. (2002c). Achievements in public health: Hepatitis B vaccination—United States, 1982–2002. Morbidity and Mortality Weekly Report, 51, 549–552,563. Retrieved from www.cdc.gov/mmwr/preview/mmwrhtml/mm5125a3.htm.
Centers for Disease Control and Prevention. (2006). Hepatitis B vaccination coverage among adults—United States, 2004. Morbidity and Mortality Weekly Report, 55, 509–511. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5518a3.htm.
Centers for Disease Control and Prevention. (2012a). Estimated HIV incidence among adults and adolescents in the United States, 2007–2010. HIV Surveillance Supplemental Report, 17, 14–22. Retrieved from http://www.cdc.gov/hiv/pdf/statistics_hssr_vol_17_no_4.pdf.
Centers for Disease Control and Prevention. (2012b). Teen vaccination coverage: 2011 National Immunization Survey (NIS)—Teen. Retrieved from www.cdc.gov/vaccines/who/teens/vaccination-coverage.html.
Centers for Disease Control and Prevention. (2012c). HIV infection and HIV-associated behaviors among injecting drug users—20 cities, United States, 2009. Morbidity and Mortality Weekly Report, 61, 133–138. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6108a1.htm.
Chesson, H. W., Gift, T. L., Owusu-Edusei, K., Jr., Tao, G., Johnson, A. P., & Kent, C. K. (2011). A brief review of the estimated economic burden of sexually transmitted diseases in the United States: Inflation-adjusted updates of previously published cost studies. Sexually Transmitted Diseases, 38, 889–891.
Constantine, N. A., & Jerman, P. (2007). Acceptance of human papillomavirus vaccination among Californian parents of daughters: A representative statewide analysis. Journal of Adolescent Health, 40, 108–115.
Derber, C. J., & Shankaran, S. (2012). Health-care worker vaccination for influenza: Strategies and controversies. Current Infectious Disease Reports, 14, 627–632.
Ferris, D., Horn, L., & Waller, J. L. (2010). Parental acceptance of a mandatory human papillomavirus (HPV) vaccination program. Journal of the American Board of Family Medicine, 23, 220–229.
Fortenberry, J. D., McFarlane, M., & Bleakley, A. (2002). Relationships of stigma and shame to gonorrhea and HIV screening. American Journal of Public Health, 92, 378–381.
Fox, J. (1991). Regression Diagnostics. Newberry Park, CA: Sage.
Gabriel, T., & Grady, D. (2011). In Republican race, a heated battle over the HPV vaccine. Retrieved from www.nytimes.com/2011/09/14/us/politics/republican-candidates-battle-over-hpv-vaccine.html.
Haber, G., Marlow, R. M., & Zimet, G. D. (2007). The HPV vaccine mandate controversy. Journal of Pediatric and Adolescent Gynecology, 20, 325–331.
Hall, H. I., Song, R., & Rhodes, P. (2008). Estimation of HIV Incidence in the United States. Journal of the American Medical Association, 300, 520–529.
Kennedy, A. M., Brown, C. J., & Gust, D. A. (2005). Vaccine beliefs of parents who oppose compulsory vaccination. Public Health Reports, 120, 252–258.
Lechuga, J., Swain, G. R., & Weinhardt, L. S. (2011). The cross-cultural variation of predictors of human papillomavirus vaccination intention. Journal of Women's Health, 20, 225–230.
McGarrigle, C. A., Mercer, C. H., Fenton, K. A., Copas, A. J., Wellings, K., Erens, B., & Johnson, A. M. (2005). Investigating the relationship between HIV testing and risk behavior in Britain: National survey of sexual attitudes and lifestyles 2000. AIDS, 19, 77–84.
Metzger, D. S., Koblin, B., Turner, C., Navaline, H., Valenti, F., Holte, S., et al. (2000). Randomized controlled trial of audio computer-assisted self-interviewing: Utility and acceptability in longitudinal studies. American Journal of Epidemiology, 152, 99–106.
National Conference of State Legislatures. (2013). HPV vaccine. Retrieved from www.ncsl.org/issues-research/health/hpv-vaccine-state-legislation-and-statues.aspx.
Newman, P. A., & Logie, C. (2010). HIV vaccine acceptability: A systematic review and meta-analysis. AIDS, 24, 1749–1756.
Newman, P. A., Duan, N., Rudy, E., Roberts, K. J., & Swendeman, D. (2004). Post-trial HIV vaccine adoption: Concerns, motivators and intentions among persons at risk for HIV. Journal of Acquired Immune Deficiency Syndromes, 37, 1393–1403.
Newman, P. A., Duan, N., Lee, S. J., Rudy, E., Seiden, D., Kakinami, L., & Cunningham, W. E. (2006a). HIV vaccine acceptability among communities at risk: The impact of vaccine characteristics. Vaccine, 24, 2094–2101.
Newman, P. A., Duan, N., Roberts, K. J., Seiden, D., Rudy, E. T., Swendeman, D., & Popova, S. (2006b). HIV vaccine trial participation among ethnic minority communities. Journal of Acquired Immune Deficiency Syndromes, 41, 210–217.
Newman, P. A., Duan, N., Lee, S. J., Rudy, E. T., Seiden, D., Kakinami, L., & Cunningham, W. E. (2007). Willingness to participate in HIV vaccine trials: The impact of trial attributes. Prevention Medicine, 44, 554–557.
Nichol, K. L., Mac Donald, R., & Hauge, M. (1996). Factors associated with influenza and pneumococcal vaccination behavior among high-risk adults. Journal of General Internal Medicine, 11, 673–677.
Ottenberg, A. L., Wu, J. T., Poland, G. A., Jacobson, R. M., Koenig, B. A., & Tilburt, J. C. (2011). Vaccinating health care workers against influenza: The ethical and legal rationale for mandate. American Journal of Public Health, 101, 212–216.
Rebmann, T., Wright, K. S., Anthony, J., Knaup, R. C., & Peters, E. B. (2012). Seasonal influenza vaccine compliance among hospital-based and nonhospital-based healthcare workers. Infection Control and Hospital Epidemiology, 33, 243–249.
Rerks-Ngarm, S., Pitisuttithum, P., Nitayaphan, S., Kaewkungwal, J., Chiu, J., Paris, R., et al. (2009). Vaccination with ALVAC and AIDSVAX to prevent HIV-1 infection in Thailand. New England Journal of Medicine, 361, 2209–2220.
Rhodes, T., Singer, M., Bourgois, P., Friedman, S. R., & Strathdee, S. A. (2005). The social structural production of HIV risk among injecting drug users. Social Science & Medince, 61, 1026–1044.
Roberts, K. J., Newman, P. A., Duan, N., & Rudy, E. T. (2005). HIV vaccine knowledge and beliefs among communities at elevated risk: Conspiracies, questions and confusion. Journal of the National Medical Association, 97, 1662–1671.
Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1994). The health belief model and HIV risk behavior change. In R. J. DiClemente & J. L. Peterson (Eds.), Preventing AIDS: Theories and methods of behavioral interventions (pp. 5–22). New York: Plenum Press.
Salmon, D. A., Moulton, L. H., Omar, S. B., DeHart, M. P., Stokley, S., & Halsey, N. A. (2005). Factors associated with refusal of childhood vaccines among parents of school-aged children: A case–control study. Archives of Pediatrics & Adolescent Medicine, 159, 470–476.
Shapiro, C. N. (1993). Epidemiology of hepatitis B. Pediatric Infectious Disease Journal, 12, 433–437.
Thomas, P. E., Voetsch, A. C., Song, B., Calloway, D., Goode, C., Mundey, L., et al. (2008). HIV risk behaviors and testing history in historically black college and university settings. Public Health Reports, 123, 115–125.
Workowski, K.A., & Berman, S. (2010). Sexually transmitted diseases treatment guidelines, 2010. Recommendations and Reports, 59, 1–110. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5912a1.htm?s_cid=rr5912a1_e.
Acknowledgments
This study was funded by a grant from NIMH (R01 MH069087). In addition, Dr. Newman received partial support by grants from the Canadian Institutes of Health Research (THA-118570) and the Canada Research Chairs program. Dr. Cunningham received partial support by grants from NIMHD (2P20MD000182), NIA (P30-AG021684), and NCRR (UL 1RR033176). Dr. Lee received partial support from NIH grants MH58107 and 5K01MH085503.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Newman, P.A., Lee, SJ., Rudy, E.T. et al. Endorsement of Compulsory HIV Vaccination Policy Among Populations at High Risk of HIV Exposure (LA VOICES). Prev Sci 15, 428–435 (2014). https://doi.org/10.1007/s11121-014-0463-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11121-014-0463-5