AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #272 - Gaps and challenges in integrating gender issues in HIV prevention research
Authors: Presenting Author: Ms. Heather Clark - International AIDS Vaccine Initiative
Additional Authors: Mr. Prince Bahati,
Aim: Both women and men face unique gender-based barriers to participating in HIV prevention research. Balanced participation is important to develop effective prevention tools; however, research has shown that women’s involvement has been inconsistent particularly in East Africa. In order to ensure optimum recruitment, enrollment and retention of volunteers, it is critical that implementation of HIV prevention research assesses gender considerations and integrates effective solutions to ensure equitable participation.
Method / Issue: In 2007, The International AIDS Vaccine Initiative (IAVI) conducted a series of 1 to 3-day participatory trainings with the objectives of increasing the understanding of gender, its role in one’s vulnerability to HIV/AIDS and the conduct of AIDS vaccine research, and to identify gender-sensitive strategies for the conduct of research. Trainings were conducted with 45 center staff and community advisory board members, 19 male and 26 female, associated with six IAVI-sponsored clinical research centers in Kenya and Uganda. Following the training, participants were asked to assess their research processes through a gender lens, identify gaps and develop action plans to redress them.
Results / Comments: While center specific gender issues were identified, a number of challenges emerged across centers: Recruitment and enrollment: Key concerns for women included the requirement to avoid pregnancy in clinical trials, blood drawing during menstruation and timing of visits. Men were concerned about the impact of participation on virility, fertility and how their blood will be used. Informed consent process: The time required to go through the informed consent is an obstacle for women because they can be distracted if accompanied by young children, might need to obtain consent from spouses and parents, have responsibilities that require them to be at home and typically have lower literacy levels than men. Voluntary Counseling and Testing: Most centers did not have counseling that proactively assesses potential gender-based violence related to participation and gender vulnerabilities to HIV/AIDS especially for female sex workers and men who have sex with men (MSM). Confidentiality and stigma: Participants’ concerns that public knowledge of study objectives or target cohort (sex workers, MSM, at-risk populations) could lead to “disclosure of sexual identity,” “sexual practice,” or “profession” which may increase gender-related stigma and social harm. Research center environment: Most centers did not have adequate facilities for childcare, IEC materials that address gender issues, or capacity to accommodate varying visit schedules.
Discussion: Indeed, gender-related gaps in HIV vaccine research do exist. Ensuring recruitment and enrollment strategies consider gender-based concerns such as the timing of sessions, integrating gender-based violence issues in counseling and creating a research center environment that is comfortable for men and women are just some of the recommended strategies to bridge these gaps. It is likely that the resultant improved volunteer experience will lead to equitable volunteer participation and sustained engagement of the community - essential for the development of AIDS vaccines and prevention technologies more broadly.
Go Back