Views and Experiences of Mucosal Sampling in HIV Clinical Research among Kenyan Volunteers

Abstract

HIV transmission predominantly occurs across mucosal surfaces. Efforts to find an effective and efficacious HIV vaccine, requires understanding the various mechanisms of sexual HIV transmission including immune responses to various HIV vaccine candidates along the mucosal pathways.  In this paper, we describe the experiences of health volunteers in three Phase 1 HIV vaccines trials and an observation study that comprised of high- risk and low risk healthy participants with regard to the collection of rectal, cervical and seminal mucosal samples. The paper emanates from a study that examined the views and experiences of volunteers in participating in HIV clinical research, at the KAVI-Institute of Clinical Research, Nairobi, Kenya. The study followed a mixed methods phenomenological research approach with a dominant qualitative strand. In the first phase, quantitative data was collected via a survey questionnaire involving 116 volunteers that helped identify 28 volunteers for the qualitative phase.  Quantitative data were analyzed using SPPS while qualitative data was transcribed verbatim, thematic themes identified for coding and entered into Atlas ti for analysis. Participants had a mean age of 28.5 ± 5.7 years (range 20–51 years). There were more males (n =85) than females (n= 31). In general, volunteers expressed mixed reactions towards the collection and use of mucosal samples. Both none-consenting and consenting volunteers cited invasiveness of their privacy.

Also reported were experiences of physical and psychological discomforts, with men terming the collection of semen via masturbation as unnatural and contravening individuals’ religious and cultural beliefs. The findings reveal a knowledge gap among community members with use of mucosal samples and modes of collection.