Ethics’of’Naonal’and’ Internaonal’Epidemiological’HIV ... ·...
Transcript of Ethics’of’Naonal’and’ Internaonal’Epidemiological’HIV ... ·...
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Ethics of Na,onal and Interna,onal Epidemiological HIV
Preven,on Research
Lloyd A. Goldsamt, Ph.D. Na,onal Development and Research
Ins,tutes, Inc.
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Confiden,ality
• Review of Confiden,ality • Consequences of Viola,ng Confiden,ality • Special Topics in Confiden,ality • Confiden,ality for Special Popula,ons • Confiden,ality Issues for Different Types of Data Collec,on
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Review of Confiden,ality
• Confiden,ality vs. Anonymity • Iden,fying Informa,on
• Federal Cer,ficate of Confiden,ality • Viola,ons of Confiden,ality
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Iden,fying Informa,on
• It’s more than just a name • “Iden,fying” depends on who has the informa,on
• Computer based iden,fiers – IP addresses – Data mining
• DNA
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Federal Cer,ficate of Confiden,ality
• Legal protec,on • No protec,on from harassment by police
• No protec,on for social consequences
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Viola,ons of Confiden,ality
• Almost always well-‐inten,oned – To help a research par,cipant in distress – Out of concern for a research par,cipant’s well-‐being
– To further the aims of an important research study
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Consequences of Viola,ng Confiden,ality
• Arrest • Physical harm (even death)
• Shame/Emo,onal Distress
• Rela,onship Distress • Harm to the Par,cipant-‐Researcher Rela,onship – For specific study/researcher/ins,tu,on – For research in general
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Special Areas of Concern
• Illegal Behaviors • S,gma,zed Behaviors
• Disease Status
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Injec,on Drug Users
• Illegal Behaviors (not only drug use) • Capacity for consent when using – Is an addicted drug user more/less able to consent when high or when in withdrawal?
• Compensa,on – Paying for drugs – Preven,ng other money-‐raising prac,ces
• HIV risk for par,cipant and others
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Youth
• Parental Consent/Assent • Youth Consent/Assent • Emancipated Minor Status
• Risks in geang consent from parents/guardians
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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MSM
• LGBTQ is really L, G, B, T and Q • S,gma (including internalized s,gma)
• HIV risk for par,cipant and others
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Individual Interviews
• Interviews in public/semi-‐public loca,ons • Interviews in private loca,ons iden,fied with specific popula,ons – Health clinics (including specialized clinics) – Research field sites
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Focus Groups
• Confiden,ality among par,cipants • Group composi,on
• Power dynamics
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Ethnography
• Par,cipant-‐Observa,on • Boundaries
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Clinical Chart Reviews
• Iden,fica,on of individuals with study topics • Disclosure of research informa,on to clinic staff
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute
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Case Studies
• IDUs • Youth • MSM
© Lloyd Goldsamt, July 2011 for the Fordham HIV Preven,on Research Ethics Training Ins,tute