Reasons for participation and experiences of women in an antibody-mediated HIV prevention clinical trial in Malawi.

Introduction: in the Antibody-Mediated Prevention (AMP) trials, a broadly neutralizing antibody called VRC01 was infused intravenously every two months to test its safety and HIV prevention efficacy. The AMP trial conducted in sub-Saharan Africa, called HVTN 703, enrolled women without HIV who were not pregnant or breastfeeding but who were behaviorally vulnerable to HIV-1 infection. We conducted a qualitative study in Malawi to explore the motivations and experiences of trial participants. Methods: between September and December 2018, we purposively selected and interviewed 12 out of 100 women enrolled in the AMP trial at the UNC Project site in Lilongwe, Malawi. We conducted in-depth interviews (IDI) with women who were retained in the trial. All IDIs were conducted in Chichewa, digitally recorded, and then transcribed into English. Data was analyzed using thematic analysis. Results: women participated in the AMP trial due to a range of perceived benefits. The primary reason was access to better quality medical care, accompanied by financial benefits and altruism. Participants' research experiences and their continued participation in the AMP trial were influenced by the research clinic environment and the nature of their interactions with research staff. Regardless of pre-existing study expectations, feeling welcomed and being able to openly interact with the study staff encouraged them to continue participating in the study. Conclusion: antibody-mediated prevention study participants enrolled and continued their participation because of perceived benefits such as access to quality health care, finances, and altruism. Provision of other health services to research participants promotes participation in the trials.