The San Francisco AIDS Foundation has just released their latest episode of their podcast featuring AIDS experts discussing hot topics of the day, this time around concerning the Thai Vaccine Trial showing a 30% preventative effect. The episode features SFAF staffer Erik Ireland and Executive Director of the AIDS Vaccine Advocacy Coalition, Mitchell Warren.
You can see here that "behavior change" is an issue, and that they regard this vaccine as not implementable because of this problematic. As Daniel Reeders has just recently argued here, implementing a 30% preventative effect among men who have no safer sex behavior to change would have a sizable impact on new transmission. But obviously the "public health nannies" (as termed by Elizabeth Pisani) don't agree.
The "no behavior change" is a huge IF. Is 30% efficacy worth the gamble? I don't think so. Plus, this vaccine was tested in a general population - high risk groups were not recruited specifically. We have no idea if it would be as effective among gay men, or sex workers, or injection drug users.
To clarify and expand my above comment... To think that you could target a vaccine so specifically (when most people engage in a combo of high, medium and low risk activities throughout their lives) - with such a low efficacy - and not see behavior change/condom migration among other groups who DO have some safe sex behavior that may change - is a huge gamble. Once a vaccine is licensed, there will be a huge cry from lots of folks who will want it. How would we only give it to the riskiest folks? How would that actually look? How would we deny this to others who wanted it, but didn't meet the criteria of high risk?