Mail & Guardian Online - September 12, 2007

Volunteers help fight against Aids: Although scientists hope that a vaccine will eventually offer the best protection against HIV infection, the complex biology of the virus has posed constant challenges and even a partially effective vaccine is still some years away.

A number of potential HIV vaccines have made it out of the laboratory, but clinical trials on humans are still only in the second of three phases. The primary goals in the current round of trials are to establish safety, dosage and their ability to trigger an immune response.

According to Samuel Rampho, a study coordinator at Aurum's research site in Klerksdorp, volunteers tend to view participation in vaccine trials as their contribution to the Aids fight. "Most would say they're very tired of this pandemic. Even if they don't benefit directly, people behind them might, so they feel it's something good they're doing for their communities."

Rampho also estimated that about 80% of trial participants had seen people close to them battle with the virus.

Chuma Ludidi (22) was motivated by the experience of watching her older sister suffer from Aids-related illnesses while trying to keep her status a secret from their devoutly Christian mother. Ludidi heard about the vaccine trial when she came to Aurum's voluntary counselling and testing (VCT) clinic last year to find out what her own HIV status was.

"Before, we never got an opportunity like this, we thought people who took part in trials were people who've got qualifications.

"I wanted to join, but during the physical screening they found out I had anaemia," she said. After being treated for the condition, Ludidi volunteered for a new vaccine trial, which is recruiting 3 000 participants between the ages of 18 and 35 at five different sites in South Africa.

Volunteering for the trial, known as "Phambili" (going forward), meant making a four-year commitment to visit the clinic at regular intervals and, in the case of female volunteers, avoiding pregnancy.

The Phambili trial is being advertised at public health clinics, local NGOs and youth centres, with slogans such as "Aids will be stopped by South Africans like you!"

Prospective participants are invited to attend an information session, in which they learn how an HIV vaccine works, the potential risks and benefits of taking part, and what would be required of them. Before signing an informed consent form, potential recruits must be HIV negative, undergo a thorough health screening and receive extensive counselling.

Rampho said one of the main challenges in recruitment has been explaining that HIV vaccines do not work like traditional vaccines, in which a weak version of the virus is administered in order to trigger the body's immune response when it is exposed to the real disease.

Instead, the vaccine delivers harmless copies of three HIV genes made in the laboratory. "We had one case where the mother of a participant was convinced her son was being injected with the HI virus," Rampho recalled. "We have to explain it doesn't work like a flu vaccine."

Volunteers are given symptom logbooks to record any side effects they might experience after having a vaccine shot. Professor Gavin Churchyard, principal investigator at the Aurum Institute in Klerksdorp, pointed out that only one participant in the phase II trial had experienced an "adverse event" that may have been related to the vaccine.

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