Population statistics on the HIV/AIDS epidemic are daunting. According to UNAIDS, during 2019, more than 1.7 million adults and children became infected with HIV and by the end of the year an estimated 38.0 million people worldwide were living with HIV/AIDS. That year witnessed 690 000 more deaths from AIDS-related illness increasing the total number of people who have died since the start of the epidemic to 32.7 million. Despite recent improvements in access to antiretroviral treatment and the success of needle exchange and other prevention programs, the rise in HIV infections continues in these populations in the U.S. and in developing and transitional countries.
The continued development and implementation of effective interventions and policies designed to prevent, reduce and ameliorate health disparities in HIV/AIDS is dependent on the knowledge generated from interventions tested by HIV scientists. Along with the benefits of a global HIV/AIDS research agenda are ethical challenges associated with the multiple vulnerabilities of persons within these populations and the unique nature of communities in which the research is conducted.
The global HIV/AIDS pandemic, shifts in drug use patterns, and advances in intervention research designs, all create new ethical challenges for studies at the intersection of HIV and drug abuse. The burden of HIV/AIDS falls hardest on a nation’s poor, people who inject or use drugs, people who are disempowered, stigmatized populations, and marginalized racial/ethnic minorities or tribal groups.
These vulnerabilities add to the complexity of ethical decision-making in HIV prevention research. Through years of experience, seasoned HIV investigators have acquired the knowledge and skills to make significant contributions to HIV ethical practices. To date, there is a paucity of well-qualified scientists with the unique investigative skills required to inform research ethics decision-making to adequately protect the rights and welfare of these vulnerable populations.
Through its intensive summer training program, funded mentored research experience, and public online resources, the Fordham University HIV and Drug Abuse Prevention Research Ethics Training Institute, directed by Dr. Celia B. Fisher, will provide early-stage clinical scientists with the competencies to address the global need for empirical and educational resources to inform research ethics practices and policies involving persons with or at-risk for HIV and drug addiction.