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Developing standards of care for HIV prevention research in developing countries – a case study of 10 research centers in Eastern and Southern Africa.

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Title: Developing standards of care for HIV prevention research in developing countries – a case study of 10 research centers in Eastern and Southern Africa.
Authors: Ngongo, PrinceBahati (AUTHOR), Priddy, Frances (AUTHOR), Park, Harriet (AUTHOR), Becker, Julie (AUTHOR), Bender, Bonnie (AUTHOR), Fast, Pat (AUTHOR), Anzala, Omu (AUTHOR), Mutua, Gaudensia (AUTHOR), Ruzagira, Eugene (AUTHOR), Kamali, Anatoli (AUTHOR), Karita, Etienne (AUTHOR), Mugo, Peter (AUTHOR), Chomba, Elwyn (AUTHOR), Bekker, Linda-Gail (AUTHOR), Roux, Surita (AUTHOR), Nanvubya, Annet (AUTHOR), Mebrahtu, Tsedal (AUTHOR)
Source: AIDS Care. Oct2012, Vol. 24 Issue 10, p1277-1289. 13p. 4 Charts, 2 Graphs.
Subjects: HIV prevention, Medical care, Circumcision, Condoms, Contraception, Counseling, Developing countries, Interviewing, Research methodology, Research evaluation, Research funding, Sexually transmitted diseases, Surveys, Highly active antiretroviral therapy, Family planning, Data analysis software, Medical coding, CD4 lymphocyte count
Geographic Terms: Africa
Abstract: Standards of care provided to volunteers in HIV prevention research in developing countries are evolving. Inconsistency in standards, particularly within a research network highlights the need to balance volunteers' health and wellness with the efficient conduct of research. Ten research centers (RC's) in East and Southern Africa affiliated with the International AIDS Vaccine Initiative (IAVI) were studied using a mixed methods approach to understand variations, similarities and gaps in services provided, recipients of services, referral systems, and barriers to referral uptake. These data were then used to develop expected standards across the 10 RCs. Findings indicated that RCs consistently provided HIV risk reduction and family planning (FP) counseling, male condoms, management of sexually transmitted infections, CD-4 counts, and general medical care to volunteers and non-research volunteers. Services that were less consistently provided on-site included: female condoms, adult male circumcision (AMC), antiretroviral therapy (ART) and post-exposure prophylaxis (PEP) in case of rape. The FP options provided on-site varied, with few providing implants, intrauterine devices, tubal ligation, and vasectomy. Most RCs had established referral systems for ART, AMC, PEP, and FP, but few had referral points for psychosocial services. Few RCs had comprehensive guidelines on referrals other than those related to adverse events. Findings indicate that the greatest challenges for referral uptake were transportation and health care costs, poor quality and inconsistency of services at some referral points. Few RCs covered the cost of referrals for non-study related adverse events. A collaborative process between IAVI and the RCs was undertaken to reach consensus on expected standards of care. A set of required and recommended services to be provided on-site or by referral was developed. In developing such standards, we tried to balance scientific priorities, equity, contextual realities, community expectations, and cost-effectiveness. [ABSTRACT FROM AUTHOR]
Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Developing standards of care for HIV prevention research in developing countries – a case study of 10 research centers in Eastern and Southern Africa.
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  Data: <searchLink fieldCode="JN" term="%22AIDS+Care%22">AIDS Care</searchLink>. Oct2012, Vol. 24 Issue 10, p1277-1289. 13p. 4 Charts, 2 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22HIV+prevention%22">HIV prevention</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care%22">Medical care</searchLink><br /><searchLink fieldCode="DE" term="%22Circumcision%22">Circumcision</searchLink><br /><searchLink fieldCode="DE" term="%22Condoms%22">Condoms</searchLink><br /><searchLink fieldCode="DE" term="%22Contraception%22">Contraception</searchLink><br /><searchLink fieldCode="DE" term="%22Counseling%22">Counseling</searchLink><br /><searchLink fieldCode="DE" term="%22Developing+countries%22">Developing countries</searchLink><br /><searchLink fieldCode="DE" term="%22Interviewing%22">Interviewing</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Research+evaluation%22">Research evaluation</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Sexually+transmitted+diseases%22">Sexually transmitted diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Surveys%22">Surveys</searchLink><br /><searchLink fieldCode="DE" term="%22Highly+active+antiretroviral+therapy%22">Highly active antiretroviral therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Family+planning%22">Family planning</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+coding%22">Medical coding</searchLink><br /><searchLink fieldCode="DE" term="%22CD4+lymphocyte+count%22">CD4 lymphocyte count</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Africa%22">Africa</searchLink>
– Name: Abstract
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  Data: Standards of care provided to volunteers in HIV prevention research in developing countries are evolving. Inconsistency in standards, particularly within a research network highlights the need to balance volunteers' health and wellness with the efficient conduct of research. Ten research centers (RC's) in East and Southern Africa affiliated with the International AIDS Vaccine Initiative (IAVI) were studied using a mixed methods approach to understand variations, similarities and gaps in services provided, recipients of services, referral systems, and barriers to referral uptake. These data were then used to develop expected standards across the 10 RCs. Findings indicated that RCs consistently provided HIV risk reduction and family planning (FP) counseling, male condoms, management of sexually transmitted infections, CD-4 counts, and general medical care to volunteers and non-research volunteers. Services that were less consistently provided on-site included: female condoms, adult male circumcision (AMC), antiretroviral therapy (ART) and post-exposure prophylaxis (PEP) in case of rape. The FP options provided on-site varied, with few providing implants, intrauterine devices, tubal ligation, and vasectomy. Most RCs had established referral systems for ART, AMC, PEP, and FP, but few had referral points for psychosocial services. Few RCs had comprehensive guidelines on referrals other than those related to adverse events. Findings indicate that the greatest challenges for referral uptake were transportation and health care costs, poor quality and inconsistency of services at some referral points. Few RCs covered the cost of referrals for non-study related adverse events. A collaborative process between IAVI and the RCs was undertaken to reach consensus on expected standards of care. A set of required and recommended services to be provided on-site or by referral was developed. In developing such standards, we tried to balance scientific priorities, equity, contextual realities, community expectations, and cost-effectiveness. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/09540121.2012.656572
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      – Code: eng
        Text: English
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        PageCount: 13
        StartPage: 1277
    Subjects:
      – SubjectFull: HIV prevention
        Type: general
      – SubjectFull: Medical care
        Type: general
      – SubjectFull: Circumcision
        Type: general
      – SubjectFull: Condoms
        Type: general
      – SubjectFull: Contraception
        Type: general
      – SubjectFull: Counseling
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      – SubjectFull: Developing countries
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      – SubjectFull: Interviewing
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      – SubjectFull: Research methodology
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      – SubjectFull: Research evaluation
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      – SubjectFull: Research funding
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      – SubjectFull: Sexually transmitted diseases
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      – SubjectFull: Surveys
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      – SubjectFull: Highly active antiretroviral therapy
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      – SubjectFull: Family planning
        Type: general
      – SubjectFull: Data analysis software
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      – SubjectFull: Medical coding
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      – SubjectFull: CD4 lymphocyte count
        Type: general
      – SubjectFull: Africa
        Type: general
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