Ethical issues associated with HIV phylogenetics in HIV transmission dynamics research: A review of the literature using the Emanuel Framework

Dev World Bioeth. 2019 Mar;19(1):25-35. doi: 10.1111/dewb.12191. Epub 2018 Mar 26.


The reduced costs of DNA sequencing and the use of such data for HIV-1 clinical management and phylogenetic analysis have led to a massive increase of HIV-1 sequences in the last few years. Phylogenetic analysis has shed light on the origin, spread and characteristics of HIV-1 epidemics and outbreaks. Phylogenetic analysis is now also being used to advance our knowledge of the drivers of HIV-1 transmission in order to design effective interventions. However, HIV phylogenetic analysis presents unique ethical challenges, which have not been fully explored. This review presents an analysis of what appear to be key ethical issues in HIV phylogenetics in the hope of stimulating further conceptual and empirical work in this rapidly emerging area. We structure the review using the Emanuel Framework, a systematic, holistic framework, which has been adapted for use in developing countries, which bear the brunt of the HIV-1 pandemic.

Keywords: HIV phylogenetics; HIV transmission dynamics; Molecular epidemiology; Public health ethics; research ethics.

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Biomedical Research / ethics
  • Developing Countries
  • Disease Outbreaks
  • Ethics, Research
  • Genetic Research / ethics*
  • HIV / genetics*
  • HIV Infections / prevention & control
  • HIV Infections / transmission
  • HIV Infections / virology*
  • Humans
  • Phylogeny*
  • Research Design*