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Vulnerability: Sex Workers in Nairobi's Majengo Slum

Published online by Cambridge University Press:  01 April 2009

PAMELA ANDANDA
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Extract

Researchers from the Universities of Oxford, Nairobi, and Manitoba are collaborating on a project to develop an HIV vaccine based on the immunological protection mechanisms found in commercial sex workers from the Majengo slum in Nairobi. This group consists of educationally and economically disadvantaged women who resort to commercial sex work for a living. A clinic was established in the slum to study sexually transmitted diseases, which now includes HIV/AIDS. The clinic serves as a research facility for the collaborating researchers who have been using the women's blood, cervical, vaginal, and saliva samples for the ongoing studies. The clinic runs two HIV-integrated activities: HIV research and HIV care and treatment. For HIV negative participants, samples are collected and used for research and care after they give informed consent.

Type
Special Section: Vulnerability Revisited
Information
Cambridge Quarterly of Healthcare Ethics , Volume 18 , Issue 2 , April 2009 , pp. 138 - 146
Copyright
Copyright © Cambridge University Press 2009

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References

1. Clearance for conducting these interviews was granted by the University of the Witwatersrand's Human Research Ethics Committee (Non-medical) Protocol Number 61110 and the Kenya Medical Research Institute's National Ethical Review Committee reference number KEMRI/RES/7/3/1.

2. Schroeder D, Gefenas E. Vulnerability: Too vague and too broad? Cambridge Quarterly of Healthcare Ethics, this issue, 113–121.

3. Interviews with Majengo participants, GenBenefit April 2007.

4. See note 3.

5. Levine C, Faden R, Grady C, Hammerschmidt D, Eckenwiler L, Sugarman J. The limitations of “vulnerability” as a protection for human research participants. The American Journal of Bioethics 2004;4(3):44–9.

6. Shivas T. Contexualising the vulnerability standard. The American Journal of Bioethics 2004;4(3):84–6 at p. 85.

7. Stone TH. The invisible vulnerable: The economically and educationally disadvantaged subjects of clinical research. The Journal of Law, Medicine and Ethics 2003;31(1):149–53 at p. 149.

8. Denny CC, Grady C. Clinical research with economically disadvantaged populations. Journal of Medical Ethics 2007;33:382–5 at p. 382.

9. See note 8, Denny, Grady 2007:383.

10. See note 8, Denny, Grady 2007:383.

11. Interview with a representative from KEMRI's ethics committee, GenBenefit April 2007.

12. See note 2, Schroeder, Genfenas, this issue.

13. Joint United Nations/World Health Organization Program on HIV/AIDS (UNAIDS/WHO). Ethical Considerations in Biomedical HIV Prevention Trials. Geneva: UNAIDS/WHO; 2007:55.

14. Whetten-Goldstein K, Nguyen TQ, Sugarman J. So much for keeping secrets: The importance of considering patients’ perspectives on maintaining confidentiality. AIDS Care 2001;13(4):457–65 at p. 462.

15. UNAIDS. Guidelines on Protecting the Confidentiality and Security of HIV Information. Proceedings from a Workshop 15–17 May 2006, Geneva, Switzerland and Interim guidelines 15 May 2007.

16. See note 11.

17. Interview with Nairobi researcher, GenBenefit, April 2007.

18. Justo L. Participatory research: A way to reduce vulnerability. The American Journal of Bioethics 2004;4(3):67–8 at p. 67.

19. See note 3.

20. Todd C. Research participation and financial inducements. The American Journal of Bioethics 2001;1(2):60–1 at p. 60.

21. See note 20, Todd 2001.

22. See note 3.

23. See note 11.

24. Hawkins SJ, Emanuel JE. Clarifying confusions about coercion. Hastings Center Report 2005;35(5):16–9 at p. 18.

25. Arnason G, Niekerk A. Undue fear of inducements in research in developing countries. Cambridge Quarterly of Healthcare Ethics, this issue, 122–129.

26. Merz JF, Magnus D, Cho MK, Caplan AL. Protecting subjects’ interests in genetics research. American Journal of Human Genetics 2002;70:965–71; Haddow G, Laurie G, Cunningham-Burley S, Hunter KG. Tackling community concerns about commercialization and genetic research: A modest interdisciplinary proposal. Social Science & Medicine 2007;64:272–82; King N. Defining and describing benefit appropriately in clinical trials. Journal of Law, Medicine and Ethics 2000;28:332–47 at p. 333.

27. HUGO Ethics Committee. 2000. Statement on Benefit Sharing. Available at http://www.hugo-international.org/Statement_on_Benefit_Sharing.htm (last accessed 15 April 2008).

28. See note 11, Representative from KEMRI's ethics committee.

29. See note 17.

30. See note 11.

31. Berg K. The ethics of benefit-sharing. Clinical Genetics 2001;59:240–3 at pp. 241–2.

32. Smaglik P. Tissue donors use their influence in deal over gene patent terms. Nature 2000;407:821.

33. Pullman D, Latus A. Benefit sharing in smaller markets: The case of Newfoundland and Labrador. Community Genetics 2003;6:178–81.

34. See note 33, Pullman, Latus 2003.

35. See note 26, Merz et al. 2002:969.

36. Ministry of Health (Kenya). The Kenya National Guidelines for Research and Development of HIV/AIDS Vaccines. March 2005.

37. See note 36, Ministry of Health 2005.

38. Andanda P. Health-related biotechnology in Africa: Managing the legislative and regulatory issues. African Journal of Medicine & Medical Sciences 2007;36(Suppl):55–61 at p. 57.

39. See note 11.

40. Winickoff DE. Governing population genomics: Law, bioethics, and biopolitics in three case studies. Jurimetrics 2003;43(2):187–228 at p. 195.

41. Alvarez-Castillo, Cook Lucas, Cordillero Castillo. Gender and vulnerable populations in benefit sharing: An exploration of conceptual and contextual points. Cambridge Quarterly of Healthcare Ethics, this issue, 130–137.

42. Council for International Organizations of Medical Sciences. International Ethical Guidelines for Biomedical Research Involving Human Subjects. Geneva: CIOMS; 2002. See also World Medical Association. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects.

43. Schroeder D. Benefit sharing: It's time for a definition. Journal of Medical Ethics 2007;33:205–9 at p. 207.

44. Andanda P. Human-tissue-related inventions: Ownership and intellectual property rights in international collaborative research in developing countries. Journal of Medical Ethics 2008;34:171–9 at pp. 177–8.

45. See note 44, Andanda 2008. The proposed checklist on page 178 may be helpful for such decisions.

46. Schroeder D, Lasen-Diaz C. Sharing the benefits of genetic resources: From biodiversity to human genetics. Developing World Bioethics 2006;5(3):135–43.

47. Available at www.incentivesforglobalhealth.org (last accessed 15 Dec 2008).