Transitions: Community Participation
Volume 14, No. 3, April 2002 This Transitions is also available in [PDF] format. By Rose McCullough, Member HVTN Global Community Advisory Board | It is irresponsible and, in fact, immoral to continue conducting business as usual—to develop a vaccine tested entirely on adults and then to wait an additional five or more years before bringing to market a vaccine for youth.
Deb Hauser, Vice President, Advocates for Youth, speaking at a press briefing in Washington, DC, November 2000, held in conjunction with the AIDS Vaccine Advocacy Coalition | Scientists and advocates agree that a vaccine is possible to prevent or reduce the risk of infection with HIV. When such a vaccine is developed and available to all at risk for HIV, it could make a major contribution to ending the global HIV/AIDS pandemic. For a vaccine to become a reality, active and broad-based community support and involvement are essential. Involving youth can make a major difference.
The statistics are overwhelming and often repeated. AIDS currently kills more people than any other infectious disease in the world. Twenty-two million people have died from AIDS and 36 million people live with HIV or AIDS. Fifty percent of all new HIV infections are in young people under age 25. To say it another way, worldwide, 7,000 individuals under age 25 become infected with HIV every day—more than 2.5 million youth each year.
Major pharmaceutical companies, government agencies, and academic researchers are conducting HIV/AIDS vaccine research. Some possible vaccines are currently being tested in people. Probably many more clinical trials will be needed before we have a safe, effective, preventive HIV/AIDS vaccine. The HIV Vaccine Trials Network (HVTN) is doing most new HIV/AIDS vaccine trials, and the Adolescent Trials Network (ATN) is responsible for trials for AIDS treatment, prevention, and vaccines in adolescents. The HVTN and the ATN are funded by the National Institutes of Health.
Why is community participation in vaccine trials critical? A vaccine trial depends on community participation. No vaccine candidate should move into human trials without the community's approbation. Community members can act as advisors to the trial, helping scientists recruit trial participants, setting trial protocols, and exploring behavioral barriers to a trial's success. Community members also act as trial participants, helping scientists to test the vaccine candidate's acceptability and efficacy.
Why is the participation of adolescents critical? Typically, trials for all sorts of proposed new vaccines, medications, and treatments are conducted first in people over the age of 17. Once an effective vaccine is found, it is then tested in children and adolescents. Imagine a world in which adults could be inoculated against HIV infection but people under age 18 would remain vulnerable to infection for as many as five to seven additional years before the vaccine could be approved for this age group. This horrifying scenario could happen if adolescents are not included in HIV vaccine trials now.
Active participation by young people—such as volunteering for HVTN community advisory boards or helping with community awareness and education—is important to speeding HIV/AIDS vaccine development. To be certain that a vaccine is available to youth under age 18 as soon as it's available for people ages 18 and older, youth and advocates need to insist that adolescents have the opportunity to enroll in vaccine trials.
Legal, procedural, perceptual, and scientific barriers pose challenges to participation in vaccine trials by youth under age 18. However, the demographics of the epidemic in the United States and around the world make it essential that young persons and advocates partner to meet this challenge, ensuring that individuals under 18 years of age participate in vaccine trials. The support of youth and of youth-serving professionals can make a difference!
For information on the HVTN and location of its sites in the United States and developing countries, go to www.hvtn.org. For information on the ATN, contact Dr. Craig Wilson at
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. For general information, contact Rose McCullough at
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.
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Transitions (ISSN 1097-1254) © 2002, is a quarterly publication of Advocates for Youth—Helping young people make safe and responsible decisions about sex. For permission to reprint, contact Transitions' editor at 202.419.3420.
Editor: Sue Alford
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