142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Peruvian FSW Perspectives on Ethics-Relevant Experiences of Participating in an HPV Vaccine Clinical Trial

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 8:30 AM - 8:42 AM

Brandon Brown, MPH Epidemiology, PhD International Health , Department of Population Health and Disease Prevention, University of California Irvine, Irvine, CA
Mariam Davtyan, MPH , University of California Irvine, Program in Public Health,, University of California Irvine, Irvine, CA
Angela Bayer, PhD , School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru
Celia Fisher , Department of Psychology, Fordham University, Bronx, NY
Aims: This qualitative study examined Peruvian female sex workers’ (FSWs) evaluation of social and health risks/benefits, informed consent, incentives, fair treatment, and post-trial care following their participation in an HPV vaccine phase IV clinical trial (GIRASOL), in which all participants received quadrivalent HPV vaccine.   

Methods: Sixteen FSWs aged 23-29 years from Lima, Peru who previously enrolled in the GIRASOL trial were administered semi-structured interviews to assess perceptions of study participation. Interviews were conducted in Spanish, audio-recorded, transcribed, and translated into English. Transcripts were coded in Atlas.ti using open and axial coding. Codes were collapsed, combined, and developed into concepts and representative quotes.    

Results: Broad themes emerging from content analysis included respect, privacy, absence of stigma, access to healthcare, and abandonment. Most participants reported staff treated them with empathy, fairness, and dignity, that participation provided protection from cancer and an opportunity to privately receive quality sexual health care, they were well prepared by consent procedures, participation was voluntary, and incentives were appropriate. Of note, one participant responded, “If nothing else, they always treated me as a human”. Unexpectedly, some experienced desertion when the study ended.    

Conclusions: Participants were generally content with all aspects of the study and emphasized its protective and non-coercive attributes. They expressed gratitude for the professional treatment despite normalized stigma regarding their FSW status. Further work may be needed to reduce feelings of abandonment.  Researchers may also need to develop navigation plans to properly transition participants out of research projects once studies have ended. 

Learning Areas:

Assessment of individual and community needs for health education
Diversity and culture
Ethics, professional and legal requirements
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe perspectives of female sex workers on clinical trial participation including voluntariness and coercion of study participation. Evaluate perceptions of social and health risks and benefits and incentives. Assess post trial care feelings and abandonment.

Keyword(s): Sex Workers, Cancer Prevention and Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator or co-investigator on multiple grants focused on health of female sex workers, and I am the principal investigator of the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.