{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:39:45Z","timestamp":1790602785946,"version":"4.1.0"},"reference-count":67,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>There is limited information about sexual behavior among volunteers who participated in phase I\/II human immunodeficiency virus (HIV) vaccine trial. This article describes the sexual behavior, practices before, and after participation in phase I\/II HIV vaccine trial in Dar es Salaam, Tanzania. We conducted a qualitative descriptive study involving volunteers who participated in the phase I\/II vaccine trial between 2007 and 2010. Purposeful sampling was used to recruit potential informants. Twenty-four in-depth interviews were conducted. The audio-recorded interviews were transcribed verbatim and analyzed using a thematic content analysis approach. The findings revealed that before participation in the HIV vaccine trial, informants were engaging in unprotected multiple sexual relationships. After the completion of the HIV vaccine trial, informants reported strengthened marital relationships, increased understanding of safer sexual practices, and HIV testing. However, the informants reported challenges regarding vaccine-induced seropositivity that adversely affected their sexual and marital relationships. Some informants re-engaged in risky sexual practices because they perceived the experimental vaccine was protective. The informants suggested having continued interventions within the community to enhance safer sexual practices. Participation in phase I\/II HIV vaccine trials may positively and negatively influence changes in volunteers\u2019 sexual behaviors and practices. The trial interventions appear to improve compliance with safer sexual practices. However, the reported vaccine-induced seropositivity and the perception that experimental vaccines are protective need further appropriate interventions.<\/jats:p>","DOI":"10.3390\/ijerph17197193","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T09:04:12Z","timestamp":1601543052000},"page":"7193","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Sexual Behaviours and Practices before and after Phase I\/II HIV Vaccine Trial: A Qualitative Study among Volunteers in Dar es Salaam Tanzania"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5881-4435","authenticated-orcid":false,"given":"Masunga K.","family":"Iseselo","sequence":"first","affiliation":[{"name":"Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania"},{"name":"Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania"},{"name":"Equity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, Tomtebodav\u00e4gen 18A, 171 77 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith A. M.","family":"Tarimo","sequence":"additional","affiliation":[{"name":"Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Sandstrom","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet, Tomtebodav\u00e4gen 18A, 171 77 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asli","family":"Kulane","sequence":"additional","affiliation":[{"name":"Equity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, Tomtebodav\u00e4gen 18A, 171 77 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,1]]},"reference":[{"key":"ref_1","unstructured":"United Nations Joint Programme on HIV\/AIDS (UNAIDS) (2020, April 04). UNAIDS Data 2019. 2019, p.476. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/2019-UNAIDS-data_en.pdf_aidsinfo.unaids.org."},{"key":"ref_2","unstructured":"NBS (2018). Tanzania HIV Impact Survey (THIS) a Population-Based HIV Impact Assessment, NBS."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/S0277-9536(96)00258-4","article-title":"Effectiveness of condoms in preventing HIV transmission","volume":"44","author":"Pinkerton","year":"1997","journal-title":"Soc. Sci. Med."},{"key":"ref_4","first-page":"35","article-title":"Assessment of youths\u2019 knowledge on the use of condom for HIV\/AIDS prevention in the North West region of Cameroon","volume":"4","author":"Fomboh","year":"2016","journal-title":"Sindhological Stud."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1093\/bmb\/58.1.155","article-title":"Behavioural interventions to prevent HIV infection: Rapid evolution, increasing rigour, moderate success","volume":"58","author":"Bonell","year":"2001","journal-title":"Br. Med. Bull."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1080\/20786204.2007.10873610","article-title":"Abstinence and faithfulness programmes for prevention of HIV\/AIDS among young people: What are the current debates?","volume":"49","author":"Setswe","year":"2007","journal-title":"S. Afr. Fam. Pract."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"25","DOI":"10.2989\/16085900709490396","article-title":"Faithfulness to partners: A means to prevent HIV infection, a source of HIV infection risks, or both? A qualitative study of women\u2019s experiences in Abidjan, C\u00f4te d\u2019Ivoire","volume":"6","author":"Painter","year":"2007","journal-title":"Afr. J. AIDS Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1177\/1557988316649927","article-title":"Condom Use in the Context of Main and Casual Partner Concurrency: Individual and Relationship Predictors in a Sample of Heterosexual African American Men","volume":"11","author":"Hicks","year":"2017","journal-title":"Am. J. Mens Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1371\/journal.pmed.0030379","article-title":"Was the \u201cABC\u201d approach (abstinence, being faithful, using condoms) responsible for Uganda\u2019s decline in HIV?","volume":"3","author":"Murphy","year":"2006","journal-title":"PLoS Med."},{"key":"ref_10","unstructured":"WHO (2012). Antiretroviral Treatment as Prevention (TasP): Opportunities and Challenges. WHO."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S95","DOI":"10.1016\/j.jfda.2013.09.043","article-title":"HIV treatment as prevention: The key to an AIDS-free generation","volume":"21","author":"Hull","year":"2013","journal-title":"J. Food Drug Anal."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1097\/OLQ.0b013e3181812939","article-title":"Changes in sexual risk behavior among participants in a prep hiv prevention trial","volume":"35","author":"Guest","year":"2008","journal-title":"Sex. Transm. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Faini, D., Hanson, C., Baisley, K., Kapiga, S., and Hayes, R. (2020). Sexual behaviour, changes in sexual behaviour and associated factors among women at high risk of HIV participating in feasibility studies for prevention trials in Tanzania. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0231766"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s11904-007-0024-7","article-title":"Risk Compensation in HIV Prevention: Implications for Vaccines, Microbicides, and Other Biomedical HIV Prevention Technologies","volume":"4","author":"Eaton","year":"2007","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1177\/1049732311431944","article-title":"Perceptions of sexual risk compensation following posttrial HIV vaccine uptake among young South Africans","volume":"22","author":"MacPhail","year":"2012","journal-title":"Qual. Health Res."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Marcus, J.L., Glidden, D.V., Mayer, K.H., Liu, A.Y., Buchbinder, S.P., Amico, K.R., Mcmahan, V., Kallas, E.G., Montoya-Herrera, O., and Pilotto, J. (2013). No Evidence of sexual risk compensation in the iPrEx trial of daily oral HIV preexposure prophylaxis. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0081997"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1258\/ijsa.2009.009378","article-title":"Anticipated changes in sexual risk behaviour following vaccination with a low-efficacy HIV vaccine: Survey results from a South African township","volume":"23","author":"Andersson","year":"2013","journal-title":"Int. J. STD AIDS"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1080\/13691050801898877","article-title":"Perceived influence of an HIV vaccine on sexual-risk behaviour in the Dominican Republic","volume":"10","author":"Barrington","year":"2008","journal-title":"Cult. Health Sex."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/01.qai.0000143600.41363.78","article-title":"HIV Sexual Risk Behavior Over 36 Months of Follow-Up in the World\u2019 s First HIV Vaccine Efficacy Trial","volume":"39","author":"Bartholow","year":"2005","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1016\/j.vaccine.2013.01.031","article-title":"Does participation in an HIV vaccine efficacy trial affect risk behaviour in South Africa?","volume":"31","author":"Gray","year":"2013","journal-title":"Vaccine"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1097\/00126334-200405010-00009","article-title":"Determinants of Enrollment in a Preventive HIV Vaccine Trial Hypothetical Versus Actual Willingness and Barriers to Participation","volume":"36","author":"Buchbinder","year":"2004","journal-title":"J. Acquir. Immune Defic. Sndromes"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1001\/jama.2010.926","article-title":"Vaccine-Induced HIV Seropositivity\/Reactivity in Noninfected HIV Vaccine Recipients","volume":"304","author":"Cooper","year":"2010","journal-title":"JAMA J. Am. Med. Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1089\/088922201750236942","article-title":"Trial-related discrimination in HIV vaccine clinical trials","volume":"17","author":"Allen","year":"2001","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1097\/QAD.0000000000002310","article-title":"Long-term safety and vaccine-induced seropositivity in healthy volunteers from HIV vaccine trials","volume":"33","author":"Durier","year":"2019","journal-title":"AIDS"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1097\/00042560-199812150-00012","article-title":"Prevention of discrimination Against Volunteers in Prophylactic HIV vaccine Trials: Lessons from a Phasse II Trial","volume":"19","author":"Sheon","year":"1998","journal-title":"J. Acquir. Immune Defic. Sndromes Hum. Retrovirol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/j.vaccine.2014.10.040","article-title":"HIV Vaccine-Induced Sero-Reactivity: A Challenge for Trial Participants, Researchers, and Physicians","volume":"33","author":"Voronin","year":"2015","journal-title":"Vaccine"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1097\/01.qai.0000127064.84325.ad","article-title":"Posttrial HIV Vaccine Adoption : Concerns, Motivators, and","volume":"37","author":"Newman","year":"2004","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Tarimo, E.A.M., Munseri, P., Aboud, S., Bakari, M., Mhalu, F., and Sandstrom, E. (2014). Experiences of social harm and changes in sexual practices among volunteers who had completed a phase I\/II HIV vaccine trial employing HIV-1 DNA priming and HIV-1 MVA boosting in Dar es Salaam, Tanzania. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0090938"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Tarimo, E.A.M., Kakoko, D.C.V., Kohi, T.W., Bakari, M., Sandstrom, E., Siyame, D., Mhalu, F., and Kulane, A. (2018). Gender aspects on HIV prevention efforts and participation in HIV vaccine trials among Police officers in Dar es Salaam, Tanzania. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5835-5"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Tarimo, E.A.M., Kohi, T.W., Bakari, M., and Kulane, A. (2013). A qualitative study of perceived risk for HIV transmission among police officers in Dar es Salaam, Tanzania. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-785"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1097\/00002030-200002180-00014","article-title":"The prevalence and incidence of HIV-1 infection and syphilis in a cohort of police officers in Dar es Salaam, Tanzania: A potential population for HIV vaccine trials","volume":"14","author":"Bakari","year":"2000","journal-title":"AIDS"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample Size in Qualitative Interview Studies : Guided by Information Power","volume":"26","author":"Malterud","year":"2016","journal-title":"Qual. Health Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.nedt.2003.10.001","article-title":"Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness","volume":"24","author":"Graneheim","year":"2004","journal-title":"Nurse Educ. Today"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1177\/135910457000100301","article-title":"Brislin. Back Translation for Cross-Cultural Research","volume":"1","author":"Richard","year":"1970","journal-title":"J. Cross Cult. Psychol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/j.1464-410X.2007.07204.x","article-title":"Sexual desire and sexual activity of men and women across their lifespans: Results from a representative German community survey","volume":"101","author":"Beutel","year":"2008","journal-title":"BJU Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1080\/00224490801987457","article-title":"Reasons why adolescents and young adults have sex: Associations with psychological characteristics and sexual behavior","volume":"45","author":"Dawson","year":"2008","journal-title":"J. Sex Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1177\/003335491012500513","article-title":"Risk and protective factors for unprotected intercourse among rural African American young adults","volume":"125","author":"Kogan","year":"2010","journal-title":"Public Health Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1007\/s10461-011-0017-9","article-title":"Substance Use and Other Risk Factors for Unprotected Sex: Results From An Event-Based Study of Homeless Youth","volume":"16","author":"Tucker","year":"2012","journal-title":"AIDS Behav."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"257","DOI":"10.2989\/16085906.2017.1358753","article-title":"Behavioural interventions promoting condom use among female sex workers in sub-Saharan Africa: A systematic review","volume":"16","author":"Okafor","year":"2017","journal-title":"Afr. J. AIDS Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-020-8384-7","article-title":"Effectiveness of the female condom in preventing HIV and sexually transmitted infections: A systematic review and meta-analysis","volume":"20","author":"Wiyeh","year":"2020","journal-title":"BMC Public Health"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Liu, H., Su, Y., Zhu, L., Xing, J., Wu, J., and Wang, N. (2014). Effectiveness of ART and condom use for prevention of sexual HIV transmission in serodiscordant couples: A systematic review and meta-analysis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0111175"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13104-015-1621-y","article-title":"Determinants of demand for condoms to prevent HIV infections among barmaids and guesthouse workers in two districts, Tanzania","volume":"8","author":"Mubyazi","year":"2015","journal-title":"BMC Res. Notes"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1080\/13625180802011302","article-title":"Barriers to condom use","volume":"13","author":"Sarkar","year":"2008","journal-title":"Eur. J. Contracept. Reprod. Health Care"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1080\/00224499.2017.1298713","article-title":"Do Associations Between Pleasure Ratings and Condom Use During Penile\u2013Vaginal Intercourse Vary by Relationship Type?: A Study of Canadian University Students","volume":"55","author":"Milhausen","year":"2017","journal-title":"J. Sex. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1007\/s10508-007-9213-0","article-title":"Sexual pleasure and condom use","volume":"36","author":"Randolph","year":"2007","journal-title":"Arch. Sex. Behav."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5402\/2012\/170739","article-title":"Motivating Factors and Psychosocial Barriers to Condom Use among out-of-School Youths in Dar es Salaam, Tanzania: A Cross Sectional Survey Using the Health Belief Model","volume":"2012","author":"Katikiro","year":"2012","journal-title":"ISRN AIDS"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1111\/j.1743-6109.2012.02700.x","article-title":"Sexual Pleasure during Condom-Protected Vaginal Sex among Heterosexual Men","volume":"9","author":"Hensel","year":"2012","journal-title":"J. Sex. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/BF00981911","article-title":"Five factors in long-term marriages","volume":"7","author":"Swensen","year":"1984","journal-title":"Lifestyles"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Velten, J., and Margraf, J. (2017). Satisfaction guaranteed? How individual, partner, and relationship factors impact sexual satisfaction within partnerships. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0172855"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"He, J., Wang, Y., Du, Z., Liao, J., He, N., and Hao, Y. (2020). Peer education for HIV prevention among high-risk groups: A systematic review and meta-analysis. BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-020-05003-9"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Nall, A., Chenneville, T., Rodriguez, L.M., and O\u2019Brien, J.L. (2019). Factors affecting hiv testing among youth in kenya. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16081450"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"10","DOI":"10.21767\/2471-9676.100045","article-title":"Factors Affecting the Attitude of Young People towards HIV Testing Uptake in Rural Ghana","volume":"4","author":"Djan","year":"2018","journal-title":"J. HIV RetroVirus"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1080\/09540120802282586","article-title":"Factors associated with HIV testing among sexually active South African youth aged 15\u201324 years","volume":"21","author":"MacPhail","year":"2009","journal-title":"AIDS Care Psychol. Socio Med. Asp. AIDS\/HIV"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1007\/s10461-015-1246-0","article-title":"Which Psychological Factors are Related to HIV Testing? A Quantitative Systematic Review of Global Studies","volume":"20","author":"Evangeli","year":"2016","journal-title":"AIDS Behav."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1097\/00042560-199903010-00015","article-title":"Evaluation of Behavioural and Social Issues among Thai HIV vaccine trial volunteers","volume":"20","author":"Thapinta","year":"1999","journal-title":"J. Acquir. Immune Defic. Sndromes Hum. Retrovirol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1080\/09540120701335212","article-title":"What should South African HIV vaccine trials do about social harms?","volume":"19","author":"Milford","year":"2007","journal-title":"AIDS Care Psychol. Socio Med. Asp. AIDS\/HIV"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.jcv.2011.01.003","article-title":"Vaccine-induced HIV seropositivity: A problem on the rise","volume":"50","author":"Koutsoukos","year":"2011","journal-title":"J. Clin. Virol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/cid\/ciy182","article-title":"Effects of Pre-exposure Prophylaxis for the Prevention of Human Immunodeficiency Virus Infection on Sexual Risk Behavior in Men Who Have Sex with Men: A Systematic Review and Meta-analysis","volume":"67","author":"Traeger","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1080\/09540120412331305124","article-title":"HIV vaccine efficacy trial participation: Men who have sex with men\u2019s experiences of risk reduction counselling and perceptions of risk behaviour change","volume":"17","author":"Guest","year":"2005","journal-title":"AIDS Care Psychol. Socio Med. Asp. AIDS\/HIV"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1155\/2013\/758682","article-title":"The role of red blood cells in enhancing or preventing HIV infection and other diseases","volume":"2013","author":"Motswaledi","year":"2013","journal-title":"BioMed. Res. Int."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Davison, G.M., Hendrickse, H.L., and Matsha, T.E. (2020). Do Blood Group Antigens and the Red Cell Membrane Influence Human Immunodeficiency Virus Infection ?. Cells, 9.","DOI":"10.3390\/cells9040845"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Motswaledi, M.S., Kasvosve, I., and Oguntibeju, O.O. (2016). Blood Group antigens, C.; Lub and P1 may have a role in HIV infection in Africans. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0149883"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1097\/QAI.0000000000001143","article-title":"Evaluation of sexual risk behavior among study participants in the TDF2 PrEP study among heterosexual adults in Botswana","volume":"73","author":"Gust","year":"2016","journal-title":"J. Acquir. Immune Defic. Sndromes"},{"key":"ref_64","unstructured":"UNAIDS (2011). Good Participatory Practice: Guideline for Biomedical HIV Prevention Trials 2011, Global Advocacy for HIV Prevention."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Tarimo, E.A.M., Ambikile, J., Munseri, P., and Bakari, M. (2019). Perception of potential harm and benefits of HIV vaccine trial participation: A qualitative study from urban Tanzania. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0224831"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1016\/j.socscimed.2006.03.032","article-title":"Community participation in AIDS vaccine trials: Empowerment or science?","volume":"63","author":"Swartz","year":"2006","journal-title":"Soc. Sci. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/BF00288071","article-title":"Sex differences in self-disclosure: Effects of topic content, friendship, and partner\u2019s sex","volume":"7","author":"Derlega","year":"1981","journal-title":"Sex Roles"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/19\/7193\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:15:38Z","timestamp":1760177738000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/19\/7193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,1]]},"references-count":67,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["ijerph17197193"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17197193","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,1]]}}}