Reassessing the Ethics of Molecular HIV Surveillance in the Era of Cluster Detection and Response: Toward HIV Data Justice

Stephen Molldrem, Anthony K.J. Smith

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

In the United States, clinical HIV data reported to surveillance systems operated by jurisdictional departments of public health are re-used for epidemiology and prevention. In 2018, all jurisdictions began using HIV genetic sequence data from clinical drug resistance tests to identify people living with HIV in “clusters” of others with genetically similar strains. This is called “molecular HIV surveillance” (MHS). In 2019, “cluster detection and response” (CDR) programs that re-use MHS data became the “fourth pillar” of the national HIV strategy. Public health re-uses of HIV data are done without consent and are a source of concern among stakeholders. This article presents three cases that illuminate bioethical challenges associated with re-uses of clinical HIV data for public health. We focus on evidence-base, risk-benefit ratio, determining directionality of HIV transmission, consent, and ethical re-use. The conclusion offers strategies for “HIV data justice.” The essay contributes to a “bioethics of the oppressed.”.

Original languageEnglish (US)
Pages (from-to)10-23
Number of pages14
JournalAmerican Journal of Bioethics
Volume20
Issue number10
DOIs
StatePublished - Oct 2 2020
Externally publishedYes

Keywords

  • confidentiality & privacy
  • genetic research
  • health policy
  • human subjects research
  • informed consent
  • Public health

ASJC Scopus subject areas

  • Issues, ethics and legal aspects
  • Health Policy

Fingerprint

Dive into the research topics of 'Reassessing the Ethics of Molecular HIV Surveillance in the Era of Cluster Detection and Response: Toward HIV Data Justice'. Together they form a unique fingerprint.

Cite this