Gradations of researchers' obligation to provide ancillary care for HIV/AIDS in developing countries

Am J Public Health. 2007 Nov;97(11):1956-61. doi: 10.2105/AJPH.2006.093658. Epub 2007 Sep 27.


Three principal factors affect the stringency of medical researchers' obligation to provide antiretroviral treatment to participants in non-HIV/AIDS studies that are conducted in developing countries: (1) the centrality of HIV/AIDS to the study design, (2) the extent of the researcher-participant interaction, and (3) the cost relative to the study budget. I provide a basis for assessing the comparative stringency of the researchers' obligation to provide this type of ancillary care. Practically, given the range of possible responses to study participants' needs, calibrating the researcher's responsibility to provide ancillary care is a useful step in ethical analysis. Theoretically, a gradation of obligation suggests how research ethics committees or institutional review boards can take multiple, potentially conflicting ethical factors into account without undertaking spurious efforts to quantify their importance.

MeSH terms

  • Acquired Immunodeficiency Syndrome / drug therapy
  • Anti-HIV Agents / administration & dosage*
  • Anti-HIV Agents / economics*
  • Antiretroviral Therapy, Highly Active* / economics
  • Biomedical Research / economics
  • Biomedical Research / ethics
  • Biomedical Research / standards*
  • Clinical Trials as Topic / economics
  • Clinical Trials as Topic / ethics
  • Developing Countries
  • Drug Costs
  • Ethics, Research
  • HIV Infections / drug therapy*
  • HIV Infections / economics
  • Humans
  • Researcher-Subject Relations / ethics


  • Anti-HIV Agents