Building Consensus for a Terminology for HIV Vaccine Induced Sero-Positivity/Reactivity


On Wednesday, Sept 4th 2013, the Global HIV Enterprise hosted a teleconference with representatives from 11 organizations in the HIV Vaccine arena. The organizations represented were:

  • Agence Nationale de Recherche sur le SIDA- Vaccine Research Institute, France
  • AIDS Vaccine Advocacy Coalition, US
  • Canadian HIV Vaccine Initiative, Canada
  • China AIDS Vaccine Initiative, China
  • European and Developing Countries Clinical Trials Partnership, The Netherlands
  • HIV Vaccine Trials Network, US
  • International AIDS Vaccine Initiative, US
  • Military HIV Research Program, US
  • National Institute of Allergy and Infectious Diseases, US
  • National Institute of Health- Vaccine Research Center, US
  • World Health Organization



The purpose of the teleconference was to discuss the need and possibility of finding a standard nomenclature to express the status of what is currently called Vaccine-Induced Sero-Positivity for participants of HIV vaccine trials. Stakeholders were engaged in the discussion ahead of the call and some had attended a convening on VISP organized in March, 2013 by the Enterprise and NIAID. Trying to identify a single terminology for VISP/R that could be broadly used by scientists, advocates, trial participants and others, was one of the recommendation made during the March consultation. As a neutral convener, the Enterprise Secretariat took the lead in bringing together stakeholders from the entire field to collaboratively examine this complex issue.


In preparation of the March convening, the Enterprise had conducted community focus groups in collaboration with the NY Blood Center, the HVTN and IAVI. The community members were asked to fill-in a survey at the end of sessions. In these reports, concerns were expressed about the two terminologies currently in use within the scientific community as well as for trial enrollment (e.g., Vaccine –Induced Sero-Positivity and Vaccine Induced Sero-Reactivity). The main concerns were the use of the word ‘Positivity’ , associated with the stigma of being HIV positive, and of the words ‘Reactivity’ and ‘sero’, deemed difficult to understand for non-scientists. During these consultations and at the March convening, suggestions were made for alternate terms to VSIP and VISR.

Those alternatives were submitted to the group ahead of the teleconference for their consideration.

The first item discussed during the call was the feasibility of having a single terminology that would be accepted by scientists, clinicians and community members. Organizations were divided on the acceptability of the existing nomenclatures:

  • Some organizations expressed the desirability to adopt a new terminology based on the same concerns about the existing terms that were expressed during focus groups with community members.

  • Some organizations have been using the term VISP or the term VISR for both lab reports and informed consent and did not encounter problems with acceptability or understanding in the community. The explanation and dialogue with the participants when introducing the concept is key, while the exact term or acronym is less important. In this context, these organizations do not perceive a need to engage in an effort to change the terminologies and acronyms already in use in their printed and online materials.

During the discussion it was pointed out that VISP, VISR and other suggested terms have slightly different meanings and could be used to more accurately convey the nuances depending on the context. For example, “reactivity” refers to the sample in a specific test and not to the person from whom the sample was taken. Another example is “Vaccine-induced antibodies”, which may be used to describe all antibodies generated by the vaccine, some of which may not react with antigens in a diagnostic test.

The conclusion of this discussion was that finding a single term to use across the field of HIV Vaccine may not be possible or even practical at this time, and that it may be more desirable to have several terms coexist, each adapted to a specific context: Diagnostic labs, trial protocols and reports, volunteers and community. It was suggested that in addition to terms currently used, alternate terminologies should be proposed and included in guidelines on VISP/R. All terms should be clearly defined to allow organizations to consider the most appropriate choice for their own purpose. It is likely that usage will ultimately drive the field-wide adoption of terminology

Some organizations had conducted internal surveys and collected opinions about the existing and new terminologies; the term ‘Vaccine Induced Antibodies ‘seemed to be favored by non-scientists, but there was no strong consensus.

There was a consensus that when publishing about the issue, no matter what term is being used in the narrative, it will be important to refer to the terms VISP and VISR, at least in footnotes, to allow for bibliographical searches and cross-references.

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