Greater ethnic diversity correlates with lower HIV prevalence in Africa: justification for an alloimmunity vaccine.

PURPOSE: After decades of research, AIDS continues to be a major pandemic and to date, adaptive immunity vaccine designs have had little to no success. Data indicate the alloimmune response is a potent mitigator of human immunodeficiency virus (HIV) infection, for which experiments of nature should be demonstrable to justify pursuit of an alloimmune vaccine strategy. We sought to determine if large-scale alloimmune diversity correlates with lower HIV infection rates. METHODS: Using published data of African linguistic groups to determine sub-Saharan country ethnicity profiles as a proxy for human leukocyte antigen (HLA) diversity, a correlation analysis was performed against respective sub-Saharan country HIV infection rates. Ethnicity data from 37 sub-Saharan nations in 2003 and from 38 nations in 2005 were used to calculate the Meyers-Macintosh ethnic diversity score for each nation as the independent variable. World Health Organization data on HIV infection rates for the same countries were used as the dependent variable. The main outcome measure was the correlation coefficient of ethnic diversity versus HIV infection rate. RESULTS: A SIGNIFICANT NEGATIVE CORRELATION WAS SHOWN BETWEEN ETHNIC DIVERSITY AND HIV INFECTION: for 2003 data, -0.4586 (two-tailed P-value of 0.0043); and, for 2005 data, -0.3866 (two-tailed P-value of 0.0165). CONCLUSION: In conjunction with substantial evidence that alloimmunity confers protection against HIV transmission and recent work identifying specific anti-HIV mechanisms, this analysis strongly justifies an HLA-based alloimmune vaccine strategy against HIV.

Cultural differences in acceptability of a vaginal microbicide: a comparison between potential users from Nashville, Tennessee, USA, and Kafue and Mumbwa, Zambia.

PURPOSE: We sought to determine the relationship between acceptability of a hypothetical vaginal microbicide, cultural factors, and perceived HIV risk among African-American women in Nashville, TN, USA, and African women in Kafue and Mumbwa, Zambia. PATIENTS AND METHODS: Women in both sites completed a survey. Regression analyses were performed on valid samples (Nashville, 164; Zambia, 101) to determine cultural differences affecting microbicide acceptability. Regression analyses also tested whether individual risk perception affected acceptability. RESULTS: In Zambia, 89.6% of women were willing to use a microbicide versus 81.6% in Nashville (P < 0.0001). One cultural difference is that women in the Zambian cohort viewed risk of HIV infection as distinct from risk of acquiring STIs, with 48% believing they were certain to become infected with AIDS, compared to 4% of Nashville participants. CONCLUSION: These results suggest a high degree of acceptability toward use of a vaginal microbicide to prevent HIV infection.