Acceptability of and willingness to pay for human immunodeficiency virus vaccination: A systematic literature review

Context: Vaccines for the human immunodeficiency virus (HIV) have considerably improved public health in the last century. Important considerations, however, are that effective vaccination substantially depends on the acceptability of future vaccines and that monetary measurements of vaccine preference, as reflected by the willingness to pay (WTP), may help policymakers establish health capital priorities. Aims: To systematically pool data on vaccine acceptability and WTP. Methods: A systematic search was performed over five databases to identify eligible articles published from 2005 to 2020, and key terms were used in accordance with the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analyses. Two researchers independently assessed the articles, extracted relevant data, and drew numerical and descriptive summaries for result presentation via Excel. Results: Out of 31 eligible studies, 28 and 3 reported on the acceptability of and WTP for HIV vaccination, respectively. Acceptability levels ranged from 2.94% to 93.10%, with the average being 60.16%, and WTP values fell between US$108 and US$671. The most prevalent themes were the characteristics of HIV vaccines (safety/side effects, efficacy, duration of protection, vaccine-induced seropositivity). Conclusions: Overall, the review uncovered a lack of standardized, universal, and acceptable scales for determining acceptability and WTP. The evaluation provided a comprehensive and systematic summary of these matters along with useful information for policymakers on maximizing public health under limited resources.