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STAKEHOLDER PERSPECTIVES ON ETHICAL CHALLENGES IN HIV VACCINE TRIALS IN SOUTH AFRICA
Author(s) -
ESSACK ZAYNAB,
KOEN JENNIFER,
BARSDORF NICOLA,
SLACK CATHERINE,
QUAYLE MICHAEL,
MILFORD CECILIA,
LINDEGGER GRAHAM,
RANCHOD CHITRA,
MUKUKA RICHARD
Publication year - 2010
Publication title -
developing world bioethics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.398
H-Index - 27
eISSN - 1471-8847
pISSN - 1471-8731
DOI - 10.1111/j.1471-8847.2009.00254.x
Subject(s) - stakeholder , confidentiality , informed consent , public relations , research ethics , context (archaeology) , ethical issues , hiv vaccine , political science , human immunodeficiency virus (hiv) , medicine , engineering ethics , family medicine , vaccine trial , alternative medicine , law , paleontology , pathology , psychiatry , biology , engineering
There is little published literature on the ethical concerns of stakeholders in HIV vaccine trials. This study explored the ethical challenges identified by various stakeholders, through an open‐ended, in‐depth approach. While the few previous studies have been largely quantitative, respondents in this study had the opportunity to spontaneously identify the issues that they perceived to be of priority concern in the South African context. Stakeholders spontaneously identified the following as ethical priorities: informed consent, social harms, collaborative relationships between research stakeholders, the participation of children and adolescents, access to treatment for participants who become infected with HIV, physical harms, fair participant and community selection, confidentiality, benefits, and payment. While there is some speculation that research in developing countries poses special ethical challenges, overall no issues were identified that have not been anticipated in international guidance, literature and popular frameworks. However, the South African context affords a distinctive gloss to these expected issues; for example, respondents were concerned that the predominant selection of black participants may perpetuate racist practices of apartheid. Stakeholders should be aware of contextual factors impacting on the implementation of ethical principles. We make a series of recommendations for South African trials, including amendments to the ethical‐legal framework and research policies, and, for further research.