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Testing for sexually transmitted infections in a population-based sexual health survey: development of an acceptable ethical approach

Field, N; Tanton, C; Mercer, CH; Nicholson, S; Soldan, K; Beddows, S; Ison, C; ... Sonnenberg, P; + view all (2012) Testing for sexually transmitted infections in a population-based sexual health survey: development of an acceptable ethical approach. Journal of Medical Ethics , 38 (6) pp. 380-382. 10.1136/medethics-2011-100068. Green open access

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Abstract

Population-based research is enhanced by biological measures, but biological sampling raises complex ethical issues. The third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3) will estimate the population prevalence of five sexually transmitted infections (STIs) (Chlamydia trachomatis, Neisseria gonorrhoeae, human papillomavirus (HPV), HIV and Mycoplasma genitalium) in a probability sample aged 16e44 years. The present work describes the development of an ethical approach to urine testing for STIs, including the process of reaching consensus on whether to return results. The following issues were considered: (1) testing for some STIs that are treatable and for which appropriate settings to obtain free testing and advice are widely available (Natsal-3 provides all respondents with STI and healthcare access information), (2) limits on test accuracy and timeliness imposed by survey conditions and sample type, (3) testing for some STIs with unknown clinical and public health implications, (4) how a uniform approach is easier to explain and understand, (5) practical difficulties in returning results and cost efficiency, such as enabling wider STI testing by not returning results. The agreed approach, to perform voluntary anonymous testing with specific consent for five STIs without returning results, was approved by stakeholders and a research ethics committee. Overall, this was acceptable to respondents in developmental piloting; 61% (68 of 111) of respondents agreed to provide a sample. The experiences reported here may inform the ethical decision making of researchers, research ethics committees and funders considering population-based biological sampling.

Type: Article
Title: Testing for sexually transmitted infections in a population-based sexual health survey: development of an acceptable ethical approach
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/medethics-2011-100068
Publisher version: http://dx.doi.org/10.1136/medethics-2011-100068
Language: English
Additional information: © 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
Keywords: ETHICS, MEDICAL ETHICS, SOCIAL ISSUES, SOCIAL SCIENCES, BIOMEDICAL, PARTICIPATE, BEHAVIOR, BRITAIN, HIV
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1336342
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