MacQueen K M, Namey E, Chilongozi D A, Mtweve S P, Mlingo M, Morar N, Reid C, Ristow A, Sahay S
Family Health International, 2224 E NC 54, Durham, NC 27713, USA.
AIDS Care. 2007 Apr;19(4):554-60. doi: 10.1080/09540120601035284.
There is on-going global debate and policy-setting concerning researchers' obligations to meet the health needs of people participating in HIV prevention trials in resource-poor settings. The perspectives of local community stakeholders on this issue are poorly understood as most of what is presented on behalf of communities where research takes place is anecdotal commentary. Using qualitative methods (130 in-depth interviews and 20 focus groups) we assessed perceived fairness of different strategies to meet the health needs of women who become HIV-infected during a hypothetical vaginal microbicide trial. Respondents included HIV prevention research participants, community stakeholders and health-care service providers in ten sites in seven countries (South Africa, Malawi, Tanzania, Zimbabwe, Zambia, India, US). Many respondents perceived referrals to be a potentially fair way to address care and treatment needs but concerns were also voiced about the adequacy of local health-care options and the ability of trial participants to access options. Most respondents viewed the provision of antiretroviral treatment by researchers to HIV-infected trial participants as unfair if treatment was not sustained beyond the end of the trial. The results underscore the importance of effectively linking trial participants to sustainable, community-based treatment and care.
关于研究人员在资源匮乏地区参与艾滋病毒预防试验的人员满足其健康需求方面的义务，全球正在进行辩论并制定相关政策。当地社区利益相关者在这个问题上的观点鲜为人知，因为代表研究开展地社区所呈现的大多是轶事性评论。我们采用定性方法（130次深入访谈和20个焦点小组），评估了在一项假设的阴道微生物杀灭剂试验中，为感染艾滋病毒的女性满足其健康需求的不同策略的公平性。受访者包括七个国家（南非、马拉维、坦桑尼亚、津巴布韦、赞比亚、印度、美国）十个地点的艾滋病毒预防研究参与者、社区利益相关者和医疗服务提供者。许多受访者认为转诊是满足护理和治疗需求的一种潜在公平方式，但也有人对当地医疗保健选择的充足性以及试验参与者获得这些选择的能力表示担忧。如果试验结束后治疗不能持续，大多数受访者认为研究人员向感染艾滋病毒的试验参与者提供抗逆转录病毒治疗是不公平的。结果强调了将试验参与者有效链接到可持续的、基于社区的治疗和护理的重要性。
