Africa Health Research Institute, KwaZulu-Natal, South Africa.
Institute for Global Health, University College London, London, UK.
Int Health. 2020 Nov 9;12(6):543-550. doi: 10.1093/inthealth/ihaa045.
We describe the findings from a research ethics case study, linked with a team evaluating a package of intervention services to prevent HIV infection in adolescent girls and young women (AGYW) living in a rural and poor setting of KwaZulu-Natal, South Africa.
We conducted qualitative interviews (n=77) with members of the linked research team evaluating the intervention programme, programme implementing staff, AGYW enrolled in the intervention programme, caregivers, ethics committee members, Public Engagement officers, community advisory board members and community stakeholders. Data were analysed iteratively using thematic framework analysis. Themes were determined by the study aims combined with an inductive development of codes emerging from the data.
The findings show that the burden of providing ancillary care fell primarily on the shoulders of frontline researchers and programme staff. Dilemmas around responding to gender-based violence illustrated the limits of 'referral to services' as a solution for meeting ancillary care obligations in contexts with barriers to basic health and social services.
Our findings show important gaps in meeting ancillary care needs. Participants' needs required social and economic support which frontline researchers and implementing partners were not able to meet, causing moral distress.
我们描述了一项研究伦理案例研究的结果，该研究与一个团队相关联，该团队评估了一整套干预服务，以预防居住在南非夸祖鲁-纳塔尔省农村和贫困地区的少女和年轻妇女（AGYW）感染艾滋病毒。
我们对参与评估干预计划的研究团队成员、实施计划的工作人员、参与干预计划的 AGYW、照顾者、伦理委员会成员、公众参与官员、社区咨询委员会成员和社区利益相关者进行了定性访谈（n=77）。使用主题框架分析对数据进行迭代分析。主题是由研究目的确定的，结合了从数据中得出的代码的归纳发展。
研究结果表明，提供辅助护理的负担主要落在一线研究人员和计划工作人员的肩上。应对基于性别的暴力的困境说明了“转介服务”作为满足辅助护理义务的解决方案的局限性，在基本卫生和社会服务存在障碍的情况下。
我们的研究结果表明，在满足辅助护理需求方面存在重要差距。参与者的需求需要社会和经济支持，而一线研究人员和实施合作伙伴无法满足，这导致了道德困境。
