Acceptability of and confidence in novel tuberculosis vaccines among South African adults living with HIV

Objectives: Several novel tuberculosis vaccines (NTVs) are being evaluated in clinical trials. Understanding the perception of acceptability and confidence in NTVs will inform implementation strategies. Methods: We conducted a cross-sectional survey to assess acceptability in and confidence of NTVs among adult persons with HIV (PWH) at two clinics in KwaZulu-Natal province, South Africa. We evaluated associations between acceptability and sociodemographic factors. Results: Among 225 PWH, 112 (50%) responded "Definitely yes, as soon as available", 86 (38%) "Definitely yes, but wait ≥6 months to receive it" and 27 (12%) "Unsure, leaning yes, any timeline" to an NTV. Acceptability was associated with perception of tuberculosis's (TB's) importance in the community, perceived risk of contracting TB, personal history of TB, not currently living with someone with TB, incompatibility of vaccines with religion, and unemployment. Most participants were confident in the vaccine's potential safety (110, 93%) and effectiveness (221, 98%). Participants preferred to receive information from government, community, and health entities, or internet, and vaccination at community settings over public health facilities. Conclusions: NTV acceptability was high amongst these PWH, and they preferred community-based delivery models. Our findings may inform strategies to increase implementation of NTVs among PWH in South Africa.