{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:16:52Z","timestamp":1760059012095,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"IAVI"},{"name":"Bill &amp; Melinda Gates Foundation"},{"name":"Ministry of Foreign Affairs of Denmark, Irish Aid"},{"name":"Ministry of Finance of Japan in partnership with The World Bank"},{"name":"Ministry of Foreign Affairs of the Netherlands"},{"name":"Norwegian Agency for Development Cooperation (NORAD)"},{"name":"United Kingdom Department for International Development (DFID)"},{"name":"United States Agency for International Development (USAID)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background\/Objectives: Fishing communities (FCs) around Lake Victoria have been identified as suitable for future HIV vaccine efficacy trials due to their high HIV incidence rates. To inform trial design and implementation, we evaluated adherence to vaccination schedules and study retention in a simulated HIV vaccine efficacy trial (SiVET) among adults from two fishing communities in Uganda. Methods: A 12-month prospective cohort study enrolled 250 HIV seronegative adults, aged 18\u201349 years, from one island and one mainland FC. The hepatitis B vaccine was administered at months 0, 1, and 6 to simulate an HIV vaccine regimen. Those testing HIV positive or pregnant were referred for care. Socio-demographic, behavioral, and clinical data were collected at baseline, 6, and 12 months. Poisson regression models with robust standard errors were used to identify factors associated with vaccination completion and retention. Results: Participants\u2019 age ranged between 25\u201334\u2009years, with a mean age of 27.6 years (SD = 6.4), and 68% of participants were from the mainland and 22% from the island. The overall vaccination completion rate was 86.5 per 100 person-years of observation (PYO), and was similar between mainland (86.8\/100 PYO) and island dwellers (85.6\/100 PYO). Male participants were likelier to complete all vaccinations [aRR = 1.1 (95% CI 1.0\u20131.2)]. Having received a secondary education or higher was also associated with higher vaccination completion compared to the rates for those with primary or no formal education [aRR = 1.1; 95% CI: 1.0\u20131.2]. Notably, participants who reported illicit drug use [aRR = 1.3; 95% CI: 1.2\u20131.4] and those engaged in paid sex [aRR = 1.2; 95% CI: 1.1\u20131.4] were more likely to complete all study visits. Conclusions: Adherence to vaccination schedules was high and consistent between mainland and island populations. These findings confirm that fishing communities are well-suited for future HIV vaccine efficacy trials. Predictors of adherence include male sex, secondary education, illicit drug use, and involvement in paid sex. High adherence rates underscore the feasibility of conducting such trials in this population.<\/jats:p>","DOI":"10.3390\/vaccines13050515","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T06:40:23Z","timestamp":1747118423000},"page":"515","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adherence to a Vaccination Schedule in a Simulated HIV Vaccine Efficacy Trial Among Adults in Fishing Communities Around Lake Victoria, Uganda"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4745-6200","authenticated-orcid":false,"given":"Sharon Barbara Nabasumba","family":"Kalenge","sequence":"first","affiliation":[{"name":"UVRI-IAVI HIV Vaccine Program, Entebbe P.O. Box 49, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Abaasa","sequence":"additional","affiliation":[{"name":"MRC\/UVRI and LSHTM Uganda Research Unit, Entebbe P.O. Box 49, Uganda"},{"name":"Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine (LSHTM), London WC1E 7HT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teddy","family":"Nakaweesi","sequence":"additional","affiliation":[{"name":"Thermofischer Scientific, Bend, OR 97701, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2115-2693","authenticated-orcid":false,"given":"Victoria Menya","family":"Biribawa","sequence":"additional","affiliation":[{"name":"UVRI-IAVI HIV Vaccine Program, Entebbe P.O. Box 49, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annet","family":"Nanvubya","sequence":"additional","affiliation":[{"name":"UVRI-IAVI HIV Vaccine Program, Entebbe P.O. Box 49, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2156-3024","authenticated-orcid":false,"given":"Ali","family":"Ssetaala","sequence":"additional","affiliation":[{"name":"UVRI-IAVI HIV Vaccine Program, Entebbe P.O. Box 49, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliet","family":"Mpendo","sequence":"additional","affiliation":[{"name":"UVRI-IAVI HIV Vaccine Program, Entebbe P.O. Box 49, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda","family":"Okech","sequence":"additional","affiliation":[{"name":"UVRI-IAVI HIV Vaccine Program, Entebbe P.O. Box 49, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matt A.","family":"Price","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA 94122, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard S.","family":"Bagaya","sequence":"additional","affiliation":[{"name":"Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala P.O. Box 7062, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noah","family":"Kiwanuka","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala P.O. Box 7062, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"doi-asserted-by":"crossref","unstructured":"The Lancet Public Health (2021). HIV 40: Inequalities fuel pandemics. Lancet Public Health, 6, e434.","key":"ref_1","DOI":"10.1016\/S2468-2667(21)00139-0"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"83","DOI":"10.5334\/aogh.4277","article-title":"Advancing the Global Fight Against HIV\/Aids: Strategies, Barriers, and the Road to Eradication","volume":"89","author":"Kumah","year":"2023","journal-title":"Ann. Glob. Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/S0140-6736(06)69157-5","article-title":"HIV\/AIDS epidemiology, pathogenesis, prevention, and treatment","volume":"368","author":"Simon","year":"2006","journal-title":"Lancet"},{"unstructured":"World Health Organisation (2025, April 08). HIV and AIDS: Key Facts. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hiv-aids.","key":"ref_4"},{"key":"ref_5","first-page":"688","article-title":"HIV\/AIDS in fishing communities: Challenges to delivering antiretroviral therapy to vulnerable groups","volume":"17","author":"Seeley","year":"2005","journal-title":"AIDS Care-Psychol. Socio-Med. Asp. AIDS\/HIV"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e346","DOI":"10.1016\/S2352-3018(25)00074-8","article-title":"Impact of an international HIV funding crisis on HIV infections and mortality in low-income and middle-income countries: A modelling study","volume":"12","author":"Brink","year":"2025","journal-title":"Lancet HIV"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1001\/jama.2017.13505","article-title":"An HIV Vaccine Is Essential for Ending the HIV\/AIDS Pandemic","volume":"318","author":"Fauci","year":"2017","journal-title":"JAMA"},{"doi-asserted-by":"crossref","unstructured":"Kaur, A., and Vaccari, M. (2024). Exploring HIV Vaccine Progress in the Pre-Clinical and Clinical Setting: From History to Future Prospects. Viruses, 16.","key":"ref_8","DOI":"10.20944\/preprints202401.0976.v1"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e289","DOI":"10.1016\/S2352-3018(16)30036-4","article-title":"Maximising HIV prevention by balancing the opportunities of today with the promises of tomorrow: A modelling study","volume":"3","author":"Smith","year":"2016","journal-title":"Lancet HIV"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3495","DOI":"10.1080\/21645515.2021.1926183","article-title":"COVID-19 vaccine hesitancy\u2013reasons and solutions to achieve a successful global vaccination campaign to tackle the ongoing pandemic","volume":"17","author":"Dhama","year":"2021","journal-title":"Hum. Vaccines Immunother."},{"doi-asserted-by":"crossref","unstructured":"Unfried, K., and Priebe, J. (2024). Vaccine hesitancy and trust in sub-Saharan Africa. Sci. Rep., 14.","key":"ref_11","DOI":"10.1038\/s41598-024-61205-0"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"100260","DOI":"10.1016\/j.jvacx.2023.100260","article-title":"COVID-19 vaccine hesitancy among health workers in rural Uganda: A mixed methods study","volume":"13","author":"Ouni","year":"2023","journal-title":"Vaccine X"},{"key":"ref_13","first-page":"4","article-title":"Prospecting for an HIV vaccine","volume":"3","author":"Crowell","year":"2017","journal-title":"Trop. Dis. Travel Med. Vaccines"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e338","DOI":"10.1016\/S2352-3018(18)30095-X","article-title":"A step forward for HIV vaccines","volume":"5","author":"Barouch","year":"2018","journal-title":"Lancet HIV"},{"doi-asserted-by":"crossref","unstructured":"Kiwanuka, N., Ssetaala, A., Nalutaaya, A., Mpendo, J., Wambuzi, M., Nanvubya, A., Sigirenda, S., Kitandwe, P.K., Nielsen, L.E., and Balyegisawa, A. (2014). High incidence of HIV-1 infection in a general population of fishing communities around Lake Victoria, Uganda. PLoS ONE, 9.","key":"ref_15","DOI":"10.1371\/journal.pone.0094932"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1136\/sti.2010.046805","article-title":"HIV and syphilis prevalence and associated risk factors among fishing communities of Lake Victoria, Uganda","volume":"87","author":"Asiki","year":"2011","journal-title":"Sex. Transm. Infect."},{"doi-asserted-by":"crossref","unstructured":"Opio, A., Muyonga, M., and Mulumba, N. (2013). HIV infection in fishing communities of Lake Victoria basin of Uganda\u2014A cross-sectional sero-behavioral survey. PLoS ONE, 8.","key":"ref_17","DOI":"10.1371\/journal.pone.0070770"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1097\/OLQ.0b013e318251555d","article-title":"High HIV incidence and socio-behavioral risk patterns in fishing communities on the shores of Lake Victoria, Uganda","volume":"39","author":"Seeley","year":"2012","journal-title":"Sex. Transm. Dis."},{"doi-asserted-by":"crossref","unstructured":"Kiwanuka, N., Mpendo, J., Nalutaaya, A., Wambuzi, M., Nanvubya, A., Kitandwe, P.K., Muyanja, E., Ssempiira, J., Balyegisawa, A., and Ssetaala, A. (2014). An assessment of fishing communities around Lake Victoria, Uganda, as potential populations for future HIV vaccine efficacy studies: An observational cohort study. BMC Public Health, 14.","key":"ref_19","DOI":"10.1186\/1471-2458-14-986"},{"doi-asserted-by":"crossref","unstructured":"Bahemuka, U.M., Abaasa, A., Ruzagira, E., Lindan, C., Price, M.A., Kamali, A., and Fast, P. (2019). Retention of adults from fishing communities in an HIV vaccine preparedness study in Masaka, Uganda. PLoS ONE, 14.","key":"ref_20","DOI":"10.1371\/journal.pone.0198460"},{"doi-asserted-by":"crossref","unstructured":"Mayanja, Y., Abaasa, A., Namale, G., Asiki, G., Price, M.A., and Kamali, A. (2019). Factors associated with vaccination completion and retention among HIV negative female sex workers enrolled in a simulated vaccine efficacy trial in Kampala, Uganda. BMC Infect. Dis., 19.","key":"ref_21","DOI":"10.1186\/s12879-019-4328-1"},{"doi-asserted-by":"crossref","unstructured":"Kamali, A., Price, M.A., Lakhi, S., Karita, E., Inambao, M., Sanders, E.J., Anzala, O., Latka, M.H., Bekker, L.-G., and Kaleebu, P. (2015). Creating an African HIV clinical research and prevention trials network: HIV prevalence, incidence and transmission. PLoS ONE, 10.","key":"ref_22","DOI":"10.1371\/journal.pone.0116100"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1016\/j.vaccine.2016.02.048","article-title":"Comparison of HIV incidence estimated in clinical trial and observational cohort settings in a high risk fishing population in Uganda: Implications for sample size estimates","volume":"34","author":"Abaasa","year":"2016","journal-title":"Vaccine"},{"unstructured":"World Health Organisation (2025, April 12). Hepatitis B. Available online: https:\/\/www.who.int\/teams\/health-product-policy-and-standards\/standards-and-specifications\/norms-and-standards\/vaccine-standardization\/hep-b.","key":"ref_24"},{"doi-asserted-by":"crossref","unstructured":"Mutisya, E.M., Muturi-Kioi, V., Abaasa, A., Nyasani, D., Kabuti, R.W., Lunani, L., Kotikot, T., Mundia, M., Mutua, G., and Ombati, G. (2022). Feasibility of conducting HIV prevention trials among key populations in Nairobi, Kenya. BMC Public Health, 22.","key":"ref_25","DOI":"10.1186\/s12889-022-14875-2"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2065","DOI":"10.1016\/j.vaccine.2019.02.072","article-title":"Simulated vaccine efficacy trials to estimate HIV incidence for actual vaccine clinical trials in key populations in Uganda","volume":"37","author":"Abaasa","year":"2019","journal-title":"Vaccine"},{"unstructured":"Ssendagire, S., Ankunda, V., Mande, S., Ayebazibwe, G.K., GeofreySeremba, G., Asio, D., Atuhurra, E.M., Kafeero, P., Kitonsa, J., and Nabukenya, S. (2024, January 6\u201310). Adherence to HIV vaccine dose schedule and associated factors among adults enrolled in a HIV vaccine trial in Uganda. Proceedings of the HIVR4P 2024, the 5th HIV Research for Prevention Conference, Lima, Peru. Available online: https:\/\/plus.iasociety.org\/sites\/default\/files\/2025-01\/e-poster.pdf.","key":"ref_27"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1186\/s13690-020-00497-w","article-title":"The gender gap and healthcare: Associations between gender roles and factors affecting healthcare access in Central Malawi, June\u2013August 2017","volume":"78","author":"Azad","year":"2020","journal-title":"Arch. Public Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.healthplace.2014.06.001","article-title":"Gender inequality and the use of maternal healthcare services in rural sub-Saharan Africa","volume":"29","author":"Adjiwanou","year":"2014","journal-title":"Health Place"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1186\/s12939-022-01678-5","article-title":"Vaccine equity in low and middle income countries: A systematic review and meta-analysis","volume":"21","author":"Ali","year":"2022","journal-title":"Int. J. Equity Health"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"agae057","DOI":"10.1093\/alcalc\/agae057","article-title":"The effect of alcohol, tobacco, and other drug use on vaccine acceptance, uptake, and adherence: A systematic review","volume":"59","author":"Havelka","year":"2024","journal-title":"Alcohol Alcohol."},{"doi-asserted-by":"crossref","unstructured":"Warren, E.A., Paterson, P., Schulz, W.S., Lees, S., Eakle, R., Stadler, J., and Larson, H.J. (2018). Risk perception and the influence on uptake and use of biomedical prevention interventions for HIV in sub-Saharan Africa: A systematic literature review. PLoS ONE, 13.","key":"ref_32","DOI":"10.1371\/journal.pone.0198680"},{"doi-asserted-by":"crossref","unstructured":"Kabarambi, A., Kansiime, S., Kusemererwa, S., Kitonsa, J., Kaleebu, P., and Ruzagira, E. (2022). Predictors of Loss to Follow-Up in an HIV Vaccine Preparedness Study in Masaka, Uganda. Int. J. Environ. Res. Public Health, 19.","key":"ref_33","DOI":"10.3390\/ijerph19116377"}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/13\/5\/515\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:31:48Z","timestamp":1760031108000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/13\/5\/515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,13]]},"references-count":33,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["vaccines13050515"],"URL":"https:\/\/doi.org\/10.3390\/vaccines13050515","relation":{},"ISSN":["2076-393X"],"issn-type":[{"type":"electronic","value":"2076-393X"}],"subject":[],"published":{"date-parts":[[2025,5,13]]}}}