Some vaccines, like those for typhoid or polio, may contain a weak form of the virus they are protecting against, but this is not the case for HIV vaccines. Scientists make HIV vaccines so that they look like the real virus, but they do not contain any HIV. Think of it like a photocopy: it might look similar, but it isn't the original. In the past 25 years more than 30,000 volunteers have taken part in HIV vaccine studies worldwide, and no one has gotten HIV by any of the study vaccines tested because they do not contain HIV.
In 2009, a large-scale vaccine study conducted in Thailand (called RV144) showed that a vaccine combination could prevent about 32 percent of new infections.
All study volunteers must go through a process called informed consent that ensures they understand all of the risks and benefits of being in a study, and those volunteers are reminded that they may leave a study at any time without losing any of their rights or benefits. The HVTN takes great care in making sure people understand the study fully before they decide whether or not to join. All HVTN studies follows U.S. federal regulations on research, as well as international ethical standards and any country-specific requirements for the countries where our research is conducted.
They must be tested on volunteers who are not living with HIV, because our goal is to keep people that way. There are other research groups that are conducting studies of therapeutic vaccines that might be used in people who are already living with HIV.
Trained counselors work with study participants to help them develop an individual plan on how to reduce their risks for HIV. Participants are also given supplies such as condoms and lubricant as well as instructions on how to use them properly. We also provide information about new HIV prevention tools that are proven effective, such as PrEP and medical male circumcision, and how participants can access these tools. HIV efficacy trials enroll thousands of participants over several years, and even with the best risk reduction efforts some participants will still get HIV. Changing human behavior is never easy; if it were, we would not have problems with obesity, or lung disease due to smoking. One of the reasons a preventive HIV vaccine is so necessary is because its effectiveness is not so dependent on people’s behavior.
The pills called Truvada and Descovy have been approved by the US Food and Drug Administration for use as PrEP. PrEP is unlikely to be an option for everyone because the pills can be expensive, may cause side effects, and may not be accessible. Remembering to take a pill every day is also challenging for some people. PrEP is an important new addition to the existing methods of HIV prevention, however, the most effective way to eliminate a disease is by using an effective vaccine. Vaccines are an effective, affordable and practical option. Until we have an effective vaccine, the HVTN supports the use of all available HIV prevention tools and encourages people to learn about their prevention options.
Current HIV medications can be expensive, and there can also be side effects. Sometimes people develop drug resistance and must change the regimen of pills they take. Access to these drugs is not guaranteed, and some middle- and low-income countries do not have access to the same medicines that are available in the US and Europe. Additionally, the rate of new infections around the world is greater than our ability to get treatment for the people who need it.
In just the past few years there have been promising results such as the discovery of new broadly neutralizing antibodies against HIV. HIV is a powerful opponent, but scientists are constantly learning from one another and using advanced technology to fight it. Science has come a long way in the almost 40 years since HIV was discovered. In comparing preventive HIV vaccine work to other vaccine development, the time it has taken is not so surprising; it took 47 years to develop the polio vaccine!
The British doctor who originally published the finding about vaccines and autism has since been found to have falsified his data and was stripped of his license to practice medicine. There is no link between childhood vaccination and autism. It is true that vaccines often have side effects, but those are typically temporary (like a sore arm, low fever, muscle aches and pains) and go away after a day or two. The value of protection to vaccinated individuals and to the public has made vaccines one of the top public health measures in history, second only to having a clean water supply.
A preventive HIV vaccine may also be important for one’s children or other family members and friends. By being knowledgeable about preventive HIV vaccine research, a person can be part of the solution by educating their friends and family about the importance of research and debunking the myths that surround it. Even if a person is not at risk today, they can be part of the effort to find a vaccine that will hopefully save the lives of millions of people worldwide.
This is especially true for groups of people that have been hardest hit by the HIV epidemic and who might benefit the most from a vaccine, such as those who live in sub-Saharan Africa. Protecting the well-being of study volunteers is the greatest responsibility in every study, and the HVTN works to make sure that studies follow the highest ethical standards and are done in collaboration with local scientists and researchers, and in consultation with local communities. Many studies are done in the US, Africa, and Latin America at the same time, and we follow the same procedures and international standards no matter where the study takes place.