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Community engagement
Organising prevention research as a clinical trial opens the way to formal review by ethical committees, providing important safeguards to trial participants. Increasingly, those organising prevention trials have seen the need for and value of a Community Advisory Board.
Most of the work that has been done on Community Advisory Boards has been in the context of preventive vaccine trials, and this is reflected in the UNAIDS ethical guidelines.
Here, the main point to make is that the same considerations apply to all of the prevention research discussed here. Most of the ethical guidance set out by UNAIDS for vaccine trials is equally applicable to microbicide trials or trials of antiretrovirals used to prevent HIV infection.
One of the critical roles of the Community Advisory Board should be, to decide on the nature of the HIV prevention efforts that should be directed at all trial participants, aside from the use of the product that is being evaluated.
It is also vital that the standard of care to be provided to any trial participant who becomes HIV positive should be discussed and agreed in advance of the trial.