Equitable treatment for HIV/AIDS clinical trial participants: a focus group study of patients, clinician researchers, and administrators in Western Kenya.
OBJECTIVE
To describe the concerns and priorities of key stakeholders in a developing country regarding ethical obligations held by researchers and perceptions of equity or "what is fair" for study participants in an HIV/AIDS clinical drug trial.


METHODS
Qualitative study with focus groups.


METHODS
Teaching and referral hospital and rural health centre in Western Kenya.


METHODS
Potential HIV/AIDS clinical trial participants, clinician researchers, and administrators.


RESULTS
Eighty nine individuals participated in a total of 11 focus groups over a four month period. The desire for continued drug therapy, most often life long, following an HIV/AIDS clinical trial was the most common priority expressed in all focus groups. Patients with and without HIV/AIDS also thought subsidizing of drug therapies and education were critical forms of compensation for clinical trial participation. Financial incentives were considered important primarily for purchasing drug therapy as well as obtaining food. Patients noted a concern for the potential mismanagement of any money offered. Clinician researchers and administrators felt strongly that researchers have a moral obligation to participants following a trial to provide continued drug therapy, adverse event monitoring, and primary care. Finally, clinician researchers and administrators stressed the need for thorough informed consent to avoid coercion of study participants.


CONCLUSIONS
Kenyan patients, clinician researchers, and administrators believe that it would be unfair to stop antiretroviral therapy following an HIV/AIDS clinical trial and that researchers have a long term obligation to participants.
Shaffer
D N
DN
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. dshaffer@kericho.mimcom.net
Yebei
V N
VN
Ballidawa
J B
JB
Sidle
J E
JE
Greene
J Y
JY
Meslin
E M
EM
Kimaiyo
S J N
SJ
Tierney
W M
WM
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000523:psychology; D000288:Administrative Personnel / Q000523:psychology; D000328:Adult; D044966:Anti-Retroviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000941:ethics* / Q000523:psychology; D003266:Continuity of Patient Care / Q000941:ethics; D017281:Cost of Illness; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007258:Informed Consent / Q000941:ethics; D007630:Kenya; D008297:Male; D028681:Moral Obligations; D010353:Patient Education as Topic / Q000941:ethics; D012108:Research Personnel / Q000523:psychology; D035842:Research Subjects / Q000523:psychology
D044966:Anti-Retroviral Agents