may also be affecting HVTN 505 recruitment. But the fact remains that more complex trials require more complex, sustained strategies for community engagement. The onus is on those proposing these ideas to invest now in materials, consultations and collaborative protocol development as outlined in the Good Participatory Practice Guidelines for Biomedical HIV Prevention Research Trials for stakeholder engagement to explain the new direction to regulators, policy makers, media, community advocates, activists and potential participants in countries where the trials might take place. Just as a truly informed consent process results in some individuals’ deciding not to enroll or to opt out early, one measure of successful communication around novel trials would be how many of these audiences weighed the information and decided that such trials weren’t right for their needs. Even before new trials can be initiated, data may emerge about new prevention methods, including PrEP, possibly antiretroviral-based microbicides, and community-wide treatment programs designed to reduce community risk. Community consultations need to incorporate discussions of how data on other interventions would be incorporated into plans for future AIDS vaccine trials. A positive finding from a single trial of PrEP or any other strategy won’t result in immediate widespread introduction. But there
will still be questions from civil society, policy makers, regulators and others about if and when such a strategy should be included in an investigational arm of a trial or as part of the standard of prevention offered to all participants.
Emphasize the positive potential of this next chapter of AIDS vaccine research There are many challenges that must be addressed as the field moves forward. But for a global endeavor, the AIDS vaccine field often feels like a small village that speaks in its own language and has its own small-town feuds and factions. All AIDS vaccine stakeholders must work together to emphasize the bottom line from the RV144 result to a broader audience: it is the first proof in humans that an AIDS vaccine can provide protection against infection. It is a cause for hope. Funding for AIDS vaccines is funding to resolve a profound public health problem. This tangible evidence should inform and motivate funding and research expansion. The field now has a place to look for a correlate and a lower bound to which future products can be compared. Carefully and thoughtfully, let us turn this page together and start writing the next one.
AVAC’s Web-based Resources In past AVAC Reports, we have published tables and timelines of ongoing AIDS vaccine and HIV prevention trials. This year, in an effort to provide the most current information, we’re inviting readers to view up-to-date versions of these resources on our website, www.avac.org. Below are quick links to these and other documents that enrich the issues discussed in this Report.
> G ood Participatory Practice Guidelines for stakeholder engagement in biomedical prevention research at www.avac.org/gpp. These guidelines are being revised and public comment is highly encouraged!
> Timeline of expected HIV prevention research efficacy trial results at www.avac.org/timeline
> Global map of ongoing biomedical HIV prevention research trials at www.avac.org/globalmap
> AIDS vaccine, PrEP and microbicides trials tables at www.avac.org/trials
> Funding for HIV prevention research at www.avac.org/resourcetracking
Turning The Pa ge
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