Testing for sexually transmitted infections in a population-based sexual health survey: development of an acceptable ethical approach
Testing for sexually transmitted infections in a population-based sexual health survey: development of an acceptable ethical approach
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DOI：
10.1136/medethics-2011-100068
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发表时间：
2012-06-01
影响因子：
4.1
通讯作者：
Sonnenberg, Pam
中科院分区：
文献类型：
--
作者：
Field, Nigel;Tanton, Clare;Sonnenberg, Pam
生物措施增强了基于人群的研究，但生物采样引发了复杂的伦理问题。第三次英国国家性态度和生活方式调查 (Natsal-3) 将估计 16-44 岁概率样本中五种性传播感染 (STI)（沙眼衣原体、淋病奈瑟菌、人乳头瘤病毒 (HPV)、艾滋病毒和生殖支原体）的人群患病率。目前的工作描述了性传播感染尿液检测道德方法的发展，包括就是否返回结果达成共识的过程。考虑了以下问题：(1) 对一些可治疗的性传播感染进行检测，并在哪些适当的环境下广泛提供免费检测和建议（Natsal-3 为所有受访者提供性传播感染和医疗保健获取信息），(2) 调查条件和样本类型对检测准确性和及时性造成的限制，(3) 对一些具有未知临床和公共卫生影响的性传播感染进行检测，(4) 统一的方法如何更容易解释和理解，(5) 返回结果和成本效率方面的实际困难，例如实现更广泛的性传播感染检测通过不返回结果。商定的方法是在明确同意的情况下对五种性传播感染进行自愿匿名测试而不返回结果，这一方法得到了利益相关者和研究伦理委员会的批准。总体而言，开发试点的受访者可以接受这一点； 61%（111 人中的 68 人）同意提供样本。这里报告的经验可以为研究人员、研究伦理委员会和资助者在考虑基于人群的生物采样时做出伦理决策提供参考。
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 16-44 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.