Abstract
BACKGROUND: Demand for a future HIV vaccine, similar to other vaccines, is vulnerable to misinformation. A number of studies have examined HIV vaccine acceptability and demand, but few have systematically explored the specific concerns and misinformation that shape these attitudes. This structured review and content analysis of published and grey literature identifies concerns about the HIV vaccine that might fuel misinformation about the vaccine when it is available. METHODS: A literature search was conducted across multiple publication databases and Google Scholar with a search strategy that used a combination of keywords. A web search was also conducted to identify other unpublished sources. Articles, including published and grey literature such as reports, were included if they were published in English and contained HIV vaccine concerns or misinformation. There was no defined timeline for article inclusion. HIV vaccine concerns extracted from the literature were documented in an Excel database and coded using NVivo V.12. Content analysis revealed several distinct topics. RESULTS: From a total of 78 articles and 9 reports, 333 concerns were extracted and included in the analysis. Seven topics emerged: (1) HIV vaccine safety, including concerns about side effects; (2) HIV vaccine causing HIV infection; (3) vaccine-related stigma and social concerns; (4) behavioural implications of the HIV vaccine, including concerns that the vaccine promotes risky behaviours; (5) conspiracy theories about the vaccine fuelled by distrust in governments and scientists; (6) concerns about partial efficacy of the vaccine and (7) HIV vaccine access, including eligibility for and availability of the vaccine. CONCLUSIONS: This review highlights key concerns about an HIV vaccine, many of which are both influenced by misinformation and could seed future misinformation campaigns. The findings can inform targeted interventions to counter misinformation and communicate the vaccine's preventive benefits to populations at highest risk of HIV.