Call for Papers
Evidence-based approaches toreducing sexual transmission of HIV has remained a major challenge inresponding to the HIV pandemic. The past 18 months has witnessed a substantial shift in this landscape. Controlled trials have demonstrated thatthe treatment of individuals with HIV infection reduces the risk of viral transmission to uninfected sexualpartners (treatment as prevention). Additional evidence suggests the possibility of providing anti-retroviralmedications to uninfected individuals may reduce the risk of acquiring HIV infection from sexualpartners (PrEP— Pre-Exposure Prophylaxis).
In view of scarce resources, therewill inevitably be a need to prioritize who will get anti-retroviral drugs;those who are sick, those who can transmit HIV, those at risk for acquiringHIV. Research that focuses on the balance between efficiency and equity will beinvolved. Ethical frameworks forguiding decision-making at the clinical level as well as the macro socialpolicy level will be essential.
Among the questions that will need tobe discussed are:
i. What rights claims can uninfected persons makefor access to ARVs for prophylactic purposes when millions across the globe aredying from AIDS because they cannot access ARV treatment? ii. What moral claims can justify the provision ofARV therapy to those who do not yet clinically require treatment as a way ofreducing the risks of HIV transmission? iii. What normative issues are raised in making the determinationthat there is sufficient evidence to demonstrate the effectiveness of either PrEPor Treatment for Prevention? iv. How should the social and biologicalvulnerability of women to HIV infection inform discussion about the allocationsof resources for either PrEP or treatment as prevention? v. If there is a risk that PrEP will increase therisk of drug resistance and compromise treatment options for those alreadyinfected, what ethical questions must be confronted? vi. What conceptions of procedural fairness andinclusiveness should shape decision making processes about these allocationdecisions?vii. How should current research findings inform theethics of trial design? viii. Given current evidence what moral issuesinvolving the protection of research subjects should be considered indetermining the extent of ancillary services and care that should be provided inprevention trials?
Thisissue of Developing World Bioethics will be guest editedby RonaldBayer (email: rb8@mail.cumc.columbia.edu) and Quarraisha AbdoolKarim (email: abdoolq2@ukzn.ac.za), Mailman School of Public Health,Columbia University, New York, NY 10032 USA.
Deadline for submissions: 31 July 2012
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