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Synergies, tensions and challenges in HIV prevention, treatment and cure research : exploratory conversations with HIV experts in South Africa

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Author(s)
Moodley, Keynthri
Staunton, Ciara
Colvin, Christopher J.
Contributor(s)
Rossouw, Theresa M.
Keywords
HIV prevention
HIV cure
Treatment
HIV clinicians
Human immunodeficiency virus (HIV)

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URI
http://hdl.handle.net/20.500.12424/696681
Online Access
http://hdl.handle.net/2263/56137
Abstract
BACKGROUND : The ethical concerns associated with HIV prevention and treatment research have been widely
 explored in South Africa over the past 3 decades. However, HIV cure research is relatively new to the region and
 significant ethical and social challenges are anticipated. There has been no published empirical enquiry in Africa
 into key informant perspectives on HIV cure research. Consequently, this study was conducted to gain preliminary
 data from South African HIV clinicians, researchers and activists.
 METHODS : In-depth interviews were conducted on a purposive sample of fourteen key informants in South Africa.
 Audiotaped interviews were transcribed verbatim with concurrent thematic analysis. The perspectives of HIV clinicians,
 researchers and activists were captured. Analyst triangulation occurred as the data were analysed by three
 authors independently.
 RESULTS : The rapid evolution of HIV cure research agendas was prominent with participants expressing some
 concern that the global North was driving the cure agenda. Participants described a symbiotic relationship
 between cure, treatment and prevention research necessitating collaboration. Assessing and managing
 knowledge and expectations around HIV cure research emerged as a central theme related to challenges to
 constructing ‘cure’ - how patients understand the idea of cure is important in explaining the complexity of cure
 research especially in the South African context where understanding of science is often challenging. Managing
 expectations and avoiding curative misconception will have implications for consent processes. Unique strategies
 in cure research could include treatment interruption, which has the potential to create therapeutic and ethical
 conflict and will be perceived as a significant risk. Ethical challenges in cure research will impact on informed
 consent and community engagement.
 CONCLUSIONS : It was encouraging to note the desire for synergy amongst researchers and clinicians working in the
 fields of prevention, treatment and cure. Translation of complex HIV cure science into lay language is critical. Moving
 forward, RECs must be adequately constituted with scientific expertise and community representation when reviewing
 cure protocols. It is hoped that knowledge and resource sharing in the context of collaboration between research
 scientists working in cure and those working in treatment and prevention will accelerate progress towards cure.
Support for this work was provided by the Social and Ethical Aspects of
 Research on Curing HIV Working Group which is supported by a NIH/NIAID
 grant (R01A108366-01: ‘Unintended and Intended Implications of HIV Cure: A
 Social and Ethical Analysis’).
http://www.biomedcentral.com/bmcmedethics
http://searchiv.web.unc.edu/
am2016
Family Medicine
Immunology
Date
2016-08-01
Type
Article
Identifier
oai:UPSpaceProd:2263/56137
Moodley, K, Rossouw, T, Staunton, C & Colvin, CJ 2016, 'Synergies, tensions and challenges in HIV prevention, treatment and cure research : exploratory conversations with HIV experts in South Africa', BMC Medical Ethics, vol. 17, art. no. 26, pp. 1-11.
1472-6939
10.1186/s12910-016-0109-1
http://hdl.handle.net/2263/56137
Copyright/License
© 2016 Moodley et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
 International License.
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