New project to look at ethics behind epidemiological tools to curb HIV transmissions

The HIV pandemic remains one of the world’s most intractable public health problems and new molecular epidemiological tools can reveal previously unseen transmission networks in communities, bolstering efforts to curb HIV’s spread. But a University of Manitoba team has received federal funding to ask a basic question: how can these data be used in a safe and effective manner in collaboration with communities affected by the HIV pandemic?

Molecular epidemiological tools are gaining popularity among researchers as they can identify previously unlinked transmissions. The anonymized data can offer many insights, but the data is far removed from the lived experiences of those hindered by the disease, so any program developed from this data may not fit the “real world” circumstances of those needing help.

Robert Lorway, Co-Principal Investigator and professor of community health sciences and Canada Research Chair in Global Intervention Politics and Social Transformation.

Lyle McKinnon, Co-Principal Investigator and an associate professor in medical microbiology and infectious disease.

But for the UM team, led by Lyle McKinnon, an associate professor in medical microbiology and infectious disease in the Rady Faculty of Health Sciences, the big question is the ethical questions that emerge from using such tools, and how these can be harnessed to guide HIV programs. 

“Do these new powerful techniques for identifying transmission patterns represent a major breakthrough to effectively tackle HIV epidemics, or do they signify the emergence of a highly intrusive surveillance regime in HIV science,” he asks.

This new study, which received $250,000 in support from Canada’s New Frontiers in Research Fund – Exploration, opens a critical and engaged dialogue with a vibrant local activist community in Kenya, Nairobi, and will offer insight into the potential uses and anticipated abuses of using such information to sharpen the focus of HIV epidemic prevention. The outcome of this process holds major importance to the development of policy frameworks that will guide the next generation of the global response.

The UM team has used such molecular tools to analyze several hundred HIV sequences within a large sex worker prevention program and noted several large, mixed transmission networks. Now, with co-lead Robert Lorway, they are directly engaging communities of male and female sex worker activists living in Nairobi, Kenya, in a critical knowledge exchange process. This will answer how, or if, these data can be ethically used to inform existing programs.

The UM has long been a trailblazer in many areas of HIV/AIDS research, including the search for a vaccine against its spread, and this project builds upon this legacy of community partnership to bolster global public health.

This study will draw upon a community based participatory approach employed by feminist and postcolonial scholars. Its multidisciplinary team of basic and social scientists, policy-makers, and local community health activists will 1) work through lay technical summaries of the molecular data to explore the possibilities and limitations of employing network interventions, 2) co-design and test, under carefully controlled conditions, a targeted pilot intervention that combines molecular network data with community knowledge and 3) critically assess and identify the emergent ethical issues, advantages and disadvantages of the tested intervention (when compared to conventional approaches).

Opening up a critical and engaged dialogue with a vibrant local activist community, will offer insight into the potential uses and anticipated abuses of using such information to sharpen the focus of HIV epidemic prevention. The outcome of this process holds major importance to the development of policy frameworks that will guide the next generation of the global response.

Research team includes:

• Robert Lorway – Co-Principal Investigator, Professor and Canada Research Chair in Global Intervention Politics and Social Transformation, Community Health Sciences, Max Rady College of Medicine
• Souradet Shaw – Co-Applicant, Assistant Professor and Canada Research Chair in Program Sciences and Global Public Health, Community Health Sciences, Max Rady College of Medicine
• Parinita Bhattacharjee – Co-Applicant, Senior Technical Advisor, Partners for Health and Development in Africa, Technical Support, Kenya
• Joshua Kimani – Co-Applicant, Clinical Director, Partners for Health and Development in Africa, Key Populations Research, Kenya
• Marissa Becker – Co-Applicant, Associate Professor, Community Health Sciences, Max Rady College of Medicine
• Marianne Mureithi – Co-Applicant, Lecturer, University of Nairobi, Medical microbiology, Kenya

UM Today Staff