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尼日利亚关于艾滋病病毒研究中的伦理辩论:政策与实践之间的差距

Debating Ethics in HIV Research: Gaps between Policy and Practice in Nigeria.

作者信息

Folayan Morenike Oluwatoyin, Peterson Kristin, Haire Bridget, Brown Brandon, Audu Kadiri, Makanjuola Olumide, Pelemo Babatunde, Marsh Vicki

出版信息

Dev World Bioeth. 2015 Dec;15(3):214-25. doi: 10.1111/dewb.12064. Epub 2014 Jun 27.

Abstract

HIV prevention is a critical health issue in Nigeria; a country that has one of the worst HIV epidemic profiles in the world. With 270,000 new infections in 2012, Nigeria is a prime site for HIV prevention research. One effect of the HIV epidemic has been to revolutionalise ethical norms for the conduct of research: it is now considered unethical to design and implement HIV related studies without community engagement. Unfortunately, there is very little commensurate effort in building the capacity of local persons to engage actively with researchers, and there is no existing platform to facilitate dialogue between researchers and communities engaged in research in Nigeria. In an effort to address this gap, we undertook a series of three community dialogues (Phase One) and two community-researcher interface meetings (Phase Two) in Nigeria. This paper aims to give an empirical account of the dialogue from these community engagement processes and provide a resulting critique of the implementation of research ethics practices in Nigeria. It is anticipated that the outputs will: (i) support researchers in designing community-based research protocols; (ii) inform ethics committees of key considerations during research protocol reviews from a community perspective; and (iii) inform policy makers and research sponsors about issues of primary concern to communities with respect to HIV research.

摘要

艾滋病病毒预防在尼日利亚是一个关键的健康问题;该国是世界上艾滋病疫情最严重的国家之一。2012年有27万例新感染病例,尼日利亚是艾滋病病毒预防研究的主要地点。艾滋病疫情的一个影响是彻底改变了研究行为的伦理规范:现在认为在没有社区参与的情况下设计和实施与艾滋病病毒相关的研究是不道德的。不幸的是,在培养当地人积极与研究人员合作的能力方面几乎没有相应的努力,而且在尼日利亚也没有现有的平台来促进研究人员与参与研究的社区之间的对话。为了弥补这一差距,我们在尼日利亚开展了一系列三次社区对话(第一阶段)和两次社区与研究人员接口会议(第二阶段)。本文旨在对这些社区参与过程中的对话进行实证描述,并对尼日利亚研究伦理实践的实施提出相应批评。预计这些成果将:(i)支持研究人员设计基于社区的研究方案;(ii)从社区角度向伦理委员会通报研究方案审查期间的关键考虑因素;(iii)向政策制定者和研究资助者通报社区在艾滋病病毒研究方面最关心的问题。

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