Journal Article

'Well, It's the Risk of the Unknown… Right?': A Qualitative Study of Perceived Risks and Benefits of HIV Cure Research in the United States

Evans, David, Skinner, Asheley, Tucker, Joseph D., Weiner, Bryan J., Taylor, Jeff, Rennie, Stuart, Greene, Sandra B., Dee, Lynda, Willenberg, Loreen, Sylla, Laurie, Dubé, Karine, Burton, Alasdair

2017

Overview

Biomedical research towards an HIV cure is advancing in the United States and elsewhere, yet little is known about perceptions of risks and benefits among potential study participants and other stakeholders. We conducted a qualitative study to explore perceived risks and benefits of investigational HIV cure research among people living with HIV (PLWHIV), biomedical HIV cure researchers, policy-makers and bioethicists. We conducted a qualitative research study using in-depth interviews with a purposive sample of PLWHIV, biomedical HIV cure researchers, policy-makers and bioethicists in 2015-2016. We analysed interview transcripts using thematic analysis anchored in grounded theory. We conducted and analyzed 36 key informant interviews. Qualitative analysis revealed four main findings. 1) Potential HIV cure study volunteers noted needing more information and education about the potential risks of HIV cure research. 2) Biomedical HIV cure researchers, policy-makers and bioethicists showed less awareness of social and financial risks of HIV cure research than PLWHIV. 3) Most respondents across the different categories of informants identified some risks that were too great to be acceptable in HIV cure research, although a subset of PLWHIV did not place an upper limit on acceptable risk. 4) PLWHIV showed a better awareness of potential psychological benefits of participating in HIV cure research than other groups of stakeholders. Our research suggests that PLWHIV have a variable understanding of the individual risks, sometimes substantial, associated with participating in biomedical HIV cure research studies. Community engagement and increased research literacy may help improve community understanding. Intensive informed consent procedures will be necessary for ethical study implementation. The current state of HIV cure research offers greater potential benefits to society than to participants. There is likely to be disagreement among regulators, researchers, clinicians, and potential participants about what constitutes acceptable risk for HIV cure studies.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acquired immune deficiency syndrome / Administrative Personnel - psychology / Adult / AIDS / Anti-HIV Agents / Attitude to Health / Bioethics / Biology and Life Sciences / Clinical trials / Clinical Trials as Topic - psychology / Community involvement / Community participation / Consent / Drug Therapy - psychology / Ethicists - psychology / Ethics / Female / Genetic Therapy - psychology / Global health / Health risks / HIV / HIV Infections - drug therapy / HIV Infections - psychology / HIV Infections - therapy / Human immunodeficiency virus / Humans / Informed consent / Interviews / Interviews as Topic / Lentivirus / Male / Medical ethics / Medical research / Medicine and Health Sciences / Middle Aged / Participation / Patients - psychology / Perceptions / Public health / Qualitative analysis / Qualitative Research / Research Personnel - psychology / Researchers / Retroviridae / Risk / Risk Assessment / Risk factors / Social Sciences / Stem cell transplantation / Stem Cell Transplantation - psychology / Studies / United States / Young Adult