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

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dc.contributor.authorMoodley, Keymanthri
dc.contributor.authorRossouw, Theresa
dc.contributor.authorStaunton, Ciara
dc.contributor.authorColvin, Christopher J
dc.date.accessioned2021-10-08T06:54:41Z
dc.date.available2021-10-08T06:54:41Z
dc.date.issued2016
dc.description.abstractAbstract 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.
dc.identifier.apacitationMoodley, K., Rossouw, T., Staunton, C., & Colvin, C. J. (2016). Synergies, tensions and challenges in HIV prevention, treatment and cure research: exploratory conversations with HIV experts in South Africa. <i>BMC Medical Ethics</i>, 17(1), 174 - 177. http://hdl.handle.net/11427/34311en_ZA
dc.identifier.chicagocitationMoodley, Keymanthri, Theresa Rossouw, Ciara Staunton, and Christopher J Colvin "Synergies, tensions and challenges in HIV prevention, treatment and cure research: exploratory conversations with HIV experts in South Africa." <i>BMC Medical Ethics</i> 17, 1. (2016): 174 - 177. http://hdl.handle.net/11427/34311en_ZA
dc.identifier.citationMoodley, K., Rossouw, T., Staunton, C. & Colvin, C.J. 2016. Synergies, tensions and challenges in HIV prevention, treatment and cure research: exploratory conversations with HIV experts in South Africa. <i>BMC Medical Ethics.</i> 17(1):174 - 177. http://hdl.handle.net/11427/34311en_ZA
dc.identifier.issn1472-6939
dc.identifier.ris TY - Journal Article AU - Moodley, Keymanthri AU - Rossouw, Theresa AU - Staunton, Ciara AU - Colvin, Christopher J AB - 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. DA - 2016 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Medical Ethics LK - https://open.uct.ac.za PY - 2016 SM - 1472-6939 T1 - Synergies, tensions and challenges in HIV prevention, treatment and cure research: exploratory conversations with HIV experts in South Africa TI - Synergies, tensions and challenges in HIV prevention, treatment and cure research: exploratory conversations with HIV experts in South Africa UR - http://hdl.handle.net/11427/34311 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34311
dc.identifier.vancouvercitationMoodley K, Rossouw T, Staunton C, Colvin CJ. Synergies, tensions and challenges in HIV prevention, treatment and cure research: exploratory conversations with HIV experts in South Africa. BMC Medical Ethics. 2016;17(1):174 - 177. http://hdl.handle.net/11427/34311.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceBMC Medical Ethics
dc.source.journalissue1
dc.source.journalvolume17
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12910-016-0109-1
dc.subject.otherAttitude
dc.subject.otherBiomedical Research
dc.subject.otherDisease Eradication
dc.subject.otherEthics, Research
dc.subject.otherFemale
dc.subject.otherHIV Infections
dc.subject.otherHumans
dc.subject.otherMale
dc.subject.otherPatient Advocacy
dc.subject.otherPhysicians
dc.subject.otherResearch Personnel
dc.subject.otherResearch Subjects
dc.subject.otherSouth Africa
dc.titleSynergies, tensions and challenges in HIV prevention, treatment and cure research: exploratory conversations with HIV experts in South Africa
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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