Marseille 2007
Marseille 2007
Abstract book
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Abstract #440  -  Perceptions of and practices in HIV clinical research in Senegal among health professionals and PLWHA.
Session:
  6.42: Posters A (Poster) on Monday   in  Chaired by
Authors:
  Presenting Author:   Mrs Couderc Mathilde - CReCSS, France
 
  Additional Authors:   
Aim:
Anthropological study of clinical research on HIV/AIDS infection in Senegal: (1) Identify and describe actors involved in conducting an HIV clinical study; (2) Analyze the perception, real-life experience and impact of an HIV clinical study for health professionals who conduct them and the patients who participate in them. Anthropological study of clinical research on HIV/AIDS infection in Senegal: (1) Identify and describe actors involved in conducting an HIV clinical study; (2) Analyze the perception, real-life experience and impact of an HIV clinical study for health professionals who conduct them and the patients who participate in them.
 
Method / Issue:
Direct observations (team meetings, consultation sessions, discussion groups) and interviews with promoters, investigators, clinical doctors, pharmacists, laboratory technicians, social workers, patients inside and outside of projects, association members, etc. A crosscutting approach for four distinct HIV clinical studies was undertaken, analyzing different steps in their process: interest in participating in an HIV clinical study; entrance into a clinical study (patient recruitment, inclusion process, obtaining patient consent); patient follow-up (caregiver-patient relationship, clinical exam, etc.); exiting and the participants situation after the clinical study.
 
Results / Comments:
Health professionals register their interest in participating in clinical studies differently. They cite professional reasons (opportunity to participate in conferences or co-author a publication, direct financial interest, etc.), or even scientific ones (improving their clinical practices, advancing research), etc. According to them, entrance into clinical research is marked by difficulties in recruiting patients (deadline pressures, competition between clinical studies, etc.), and bias in the doctors authority for obtaining consent. In terms of patient follow-up, difficulties such as the lack of specific training and strictness of protocols are often mentioned. Their main concern lies in what will become of them and their patients at the studys end. The acceptance of PLWHA to participate in a study responds to several factors (the idea of better clinical and therapeutic follow-up, the doctors authority, economic relief due to quasi-total medical-social care provided by the study). However, the participants level of understanding about the internal culture of a clinical study remains limited (unawareness regarding participants rights, specific terms, advantages and constraints, the study's duration etc.), and may represent an obstacle to their support of the project. Additionally, we were able to note the circulation of information between PLWHA regarding clinical studies in progress. Topics included the desire among patients outside the clinical study to benefit from the same care as participants in the study and the demand among associations to be better informed on the objectives and progress of a clinical study.
 
Discussion:
By allowing for improved understanding of the interactions between actors involved in running an HIV clinical study (their expectations, their questions, the difficulties encountered, the exchanges that are created), this study demonstrates the interest in systematic articulation between the implementation of any HIV clinical study and a support mechanism for health professionals and concerned participants (specific training and awareness-raising).
 
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