Engaging with research ethics in central Francophone Africa: reflections on a workshop about ancillary care

Research ethics is predominantly taught and practiced in Anglophone countries, particularly those in North America and Western Europe. Initiatives to build research ethics capacity in developing countries must attempt to avoid imposing foreign frameworks and engage with ethical issues in research that are locally relevant. This article describes the process and outcomes of a capacity-building workshop that took place in Kinshasa, Democratic Republic of Congo in the summer of 2011. Although the workshop focused on a specific ethical theme – the responsibilities of researchers to provide health-related care to their research participants – we argue that the structure of the workshop offers a useful method for engaging with research ethics in general, and the theme of ancillary care encourages a broad perspective on research ethics that is highly pertinent in low-income countries. The workshop follows an interactive, locally driven model that could be fruitfully replicated in similar settings

Barriers to and Facilitators of Adherence to Pediatric Antiretroviral Therapy in a Sub-Saharan Setting: Insights from a Qualitative Study

Despite the need for HIV-positive children to adhere effectively to antiretroviral treatment (ART), a guiding theory for pediatric ART in resource-limited settings is still missing. Understanding factors that influence pediatric ART adherence is critical to developing adequate strategies. In-depth qualitative interviews were undertaken in Kinshasa, Democratic Republic of the Congo, with 20 sets of HIV disclosed and nondisclosed children along with respective caregivers to better characterize barriers, facilitators, and adherence experiences in children taking ART. Commonly cited barriers included lack of food or nutritional support, lack of assistance or supervision for children, lack of assistance for caregivers, and being unable to remember to take medicines on a consistent basis. Facilitators included having a strong caregiver–child relationship and support system along with strategies for maintaining adherence. Similar themes arose within the child–caregiver sets, but were often characterized differently between the two. Children who were aware of their HIV status displayed fewer instances of frustration and conflict concerning taking medicines and within the child–caregiver relationship. Continued study on pediatric ART adherence should account for differing perspectives of children and caregivers, as well as between status disclosed and nondisclosed children. Areas of future intervention should focus on child–caregiver relationships, disclosure of HIV status, and available nutritional and psychosocial support for children and their caregivers

Antenatal and delivery services in Kinshasa, Democratic Republic of Congo: care-seeking and experiences reported by women in a household-based survey

Increasing coverage of quality reproductive health services, including prevention of mother-to-child transmission services, requires understanding where and how these services are provided. To inform scale-up, we conducted a population-based survey in Kinshasa, Democratic Republic of Congo

The Structure and Function of Research Ethics Committees in Africa: A Case Study

Kass and colleagues explore the strengths and weaknesses of research ethics committees in Africa

Terms Used for People Living With HIV in the Democratic Republic of the Congo

For this study we conducted in-depth interviews with 29 youth living with HIV (YLWH) and key informant interviews with 8 HIV care/support providers. We describe terms used to portray people living with HIV (PLWH) in Kinshasa, Democratic Republic of the Congo. Labels commonly used, mostly derogatory, described PLWH as walking corpses, dangers to others, or people deserving to die before others get infected. Blame and other accusations were directed at PLWH through anchoring or objectification. Being labeled sometimes made these youth suffer in silence, afraid to disclose their status, or avoid performing actions in public, preferring to let others do them. YLWH need psychosocial support to mitigate the harmful effects of these labels and strengthen their coping skills, whereas community, institutional, and national efforts are needed for stigma reduction

Conducting Unlinked Anonymous HIV Surveillance in Developing Countries: Ethical, Epidemiological, and Public Health Concerns

Stuart Rennie and colleagues argue that while unlinked anonymous HIV testing is valuable and ethical, such surveillance can be conducted in ethically questionable ways in certain circumstances

Stigmatisation et vulnérabilité chez les jeunes vivant avec le VIH à Kinshasa en République Démocratique du Congo : essai de « sociobioéthique »

Beyond the usual philosophical thinking in bioethics, this thesis proposes contractualist "sociobioethics" as an ethical analysis grid for the "justifiability" of stigmatization of youth living with HIV (YLWH). Perception of stigma from 150 YLWH in Kinshasa is analyzed and the association between this perception and psychosocial vulnerability of these youth is modeled. Results show that 47.3% of YLWH perceived themselves stigmatized , 17.3 % had depressive symptoms and 54.6% had low level of social support. Surprisingly, there is a significant negative correlation between stigma and depressive symptoms (-0.230; p = 0.005) and a significant positive correlation between stigma and social support (0.233; p = 0.004). For an ethic of social justice in vulnerability situations and transformative recognition, the YLWH should be protected from stigma, since there is shared responsibility and necessity for fairness.Cette thèse propose, au-delà de la réflexion philosophique courante en bioéthique, la « sociobioéthique » contractualiste comme grille d'analyse éthique de la « justifiabilité » de la stigmatisation de jeunes vivant avec le VIH (JVVIH). Y est analysée la perception de stigmatisation de 150 JVVIH de Kinshasa, et modélisée l'association entre cette perception et la vulnérabilité psychosociale de ces jeunes. Il en ressort que 47,3% de jeunes se perçoivent stigmatisés, que 17,3% ont des symptômes dépressifs et que 54,6% ont un faible niveau de soutien social. Il y a curieusement corrélation négative significative entre stigmatisation et symptômes dépressifs (-0,230; p=0,005) et corrélation positive significative entre stigmatisation et soutien social (0,233; p=0,004). Pour une éthique de la justice sociale en situation de vulnérabilité, on devrait protéger les JVVIH de la stigmatisation, par souci d'équité et vue une responsabilité partagée pour une reconnaissance transformative.(SP - Sciences de la santé publique) -- UCL, 201