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Suicide Behaviour Among Adolescents in a High HIV Prevalence Region of Western Kenya: A Mixed Methods Study

March 15, 2021

The study purpose was to determine the prevalence and determinants of suicidal thoughts and behaviours in a rural community sample of 15–19-year-old Kenyan adolescents in a region with high HIV burden. Data were from an observational study examining ethical issues in adolescent HIV research (N=4084). Participants reporting suicidal ideation were assessed for suicide risk. Directed … Continued

HIV Prevention Research and COVID-19: Putting Ethics Guidance to the Test

January 27, 2021

Background Critical public health measures implemented to mitigate the spread of the novel coronavirus disease (COVID-19) pandemic have disrupted health research worldwide, including HIV prevention research. While general guidance has been issued for the responsible conduct of research in these challenging circumstances, the contours of the dueling COVID-19 and HIV/AIDS pandemics raise some critical ethical … Continued

Cohorts as Collections of Bodies and Communities of Persons: Insights from the SEARCH010/RV254 Research Cohort

November 10, 2020

Longitudinal research cohorts are uniquely suited to answer research questions about morbidity and mortality. Cohorts may be comprised of individuals identified by specific conditions or other shared traits. We argue that research cohorts are more than simply aggregations of individuals and their associated data to meet research objectives. They are social communities comprised of members, … Continued

Ethics of Pursuing Targets in Public Health the Case of Voluntary Medical Male Circumcision for HIV Prevention Programs in Kenya.

November 4, 2020

The use of targets to direct public health programmes, particularly in global initiatives, has become widely accepted and commonplace. This paper is an ethical analysis of the utilisation of targets in global public health using our fieldwork on and experiences with voluntary medical male circumcision (VMMC) initiatives in Kenya. Among the many countries involved in … Continued

Recommendations from Thai Stakeholders About Protecting HIV Remission (‘cure’) Trial Participants: Report from a Participatory Workshop

November 1, 2020

Background The social/behavioral HIV Decision-Making Study (DMS) assesses informed consent and trial experiences of individuals in HIV remission trials in Thailand. We convened a 1-d multi-stakeholder participatory workshop in Bangkok. We provide a meeting summary and reactions from DMS investigators. Methods Workshop members viewed de-identified interview excerpts from DMS participants. They deliberated on the findings … Continued

HIV Molecular Epidemiology: Tool of Oppression or Empowerment?

September 30, 2020

Molldrem and Smith (2020) are to be commended for their insightful analysis of a public health practice that has received little attention among bioethicists: the use of molecular HIV surveillance (MHS) and cluster detection and response (CDR) for epidemiology and prevention. We agree with the authors that these methodologies raise potential issues of justice in … Continued

Moral practices shaping HIV disclosure among young gay and bisexual men living with HIV in the context of biomedical advance

September 30, 2020

Biomedical advances in diagnostics, treatment and prevention increase the means available to reduce HIV transmission risk. Subsequent shifts in HIV status disclosure obligation and ethics may impact how those living with HIV view, enact and experience disclosure. We analysed focus group and interview data to explore how these changes are reflected in disclosure decision-making to … Continued

Comparative strategic approaches to COVID-19 in Africa: Balancing public interest with civil liberties

September 29, 2020

As COVID-19 spreads rapidly across Africa, causing havoc to economies and disruption to already fragile healthcare systems, it is becoming clear that despite standardised global health strategies, national and local government responses must be tailored to their individual settings. Some African countries have adopted stringent measures such as national lockdown, quarantine or isolation, in combination … Continued

Allocation of scarce resources in Africa during COVID‐19: Utility and justice for the bottom of the pyramid?

September 29, 2020

The COVID‐19 pandemic has raised important universal public health challenges. Conceiving ethical responses to these challenges is a public health imperative but must take context into account. This is particularly important in sub‐Saharan Africa (SSA). In this paper, we examine how some of the ethical recommendations offered so far in high‐income countries might appear from … Continued

Practical and Ethical Concerns in Implementing Enhanced Surveillance Methods to Improve Continuity of HIV Care: Qualitative Expert Stakeholder Study

September 16, 2020

Background: Retention in HIV care is critical to maintaining viral suppression and preventing further transmission, yet less than 50% of people living with HIV in the United States are engaged in care. All US states have a funding mandate to implement Data-to-Care (D2C) programs, which use surveillance data (eg, laboratory, Medicaid billing) to identify out-of-care … Continued