Integrating research into routine service delivery in an antiretroviral treatment programme: lessons learnt from a cluster randomized trial comparing strategies of HIV care in Jinja, Uganda.
Trials integrated into normal health service delivery are designed to evaluate the effectiveness of interventions under real-life conditions. However, integrating research into service delivery creates many operational challenges and raises ethical dilemmas. Here we discuss the operational and ethical issues arising from such trials using the example of a cluster randomized trial evaluating two strategies of ART delivery in Jinja, south-east Uganda.
Jaffar
Shabbar
S
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. shabbar.jaffar@lshtm.ac.uk
Amuron
Barbara
B
Birungi
Josephine
J
Namara
Geoffrey
G
Nabiryo
Christine
C
Coutinho
Alex
A
Grosskurth
Heiner
H
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D035843:Biomedical Research; D003695:Delivery of Health Care / Q000458:organization & administration*; D004059:Diffusion of Innovation; D032984:Ethics, Research; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000941:ethics; D012107:Research Design; D014454:Uganda; D016526:Workload
D019380:Anti-HIV Agents