Abstract

Improving participatory practices for sex workers' involvement in biomedical HIV prevention trials

D. Allman¹, M.H. Ditmore<sup>2,3

1</sup>University of Toronto, HIV Social, Behavioural and Epidemiological Studies Unit, Toronto, Canada, ²National Development and Research Institutes, Inc., New York, United States, ³Public Health Solutions, New York, United States

Background: UNAIDS/AVAC developed Good Participatory Practice Guidelines for Biomedical HIV Prevention Trials (GPP) in order to provide systematic guidance regarding researchers' roles and responsibilities toward participant communities. As sex workers are a population frequently targeted for involvement in biomedical HIV prevention trials, this project investigated sex workers' reactions to involvement in such trials in general, and knowledge of the GPP's core guiding principles specifically.
Methods: A 33-question survey addressing 10 core principles of GPP were conducted in English, French, and Spanish. Most were self-completed unless low literacy levels required otherwise. Self-identified sex workers were recruited through peer networks. Responses were received electronically, in person and on paper. No incentives were offered.
Results: Seventy-four sex workers responded to the survey. Of those indicating region of residence, 10% were from the Asia Pacific, 15% from Latin America, 18% from Europe and 57% from North America. 30% of participants reported first hand involvement in biomedical HIV prevention trials. Many participants were not opposed to co-operation with trials, but would want to learn more about research before committing. Many would consider involvement in prevention trials provided they were confident a trial was ethical and participatory. Improving effective communications between trial sites and community stakeholders was identified as key. 'Respect' for members of the community was the most important GPP principle identified by sex workers.
Conclusions: In this convenience sample of sex workers, there was varied understanding of the workings of biomedical HIV prevention trials. There was, however, considerable understanding of the stigma and disrespect that could be experienced by sex workers within such trial contexts. Taken together, results suggest trial participation can be improved through techniques to help develop greater respect for trial participants, more attention to research capacity building, and continued translation of both standard and more complex research processes into local languages using non-technical terms.