Skip to main content

Rethinking Risks and Benefits in Stakeholder-Engaged Research: Lessons from HIV, Substance Use, and Sexual Health Research with Marginalized Communities

  • Chapter
  • First Online:
Ethical Issues in Community and Patient Stakeholder–Engaged Health Research

Part of the book series: Philosophy and Medicine ((PHME,volume 146))

  • 178 Accesses

Abstract

In this chapter, we discuss the ways in which the weighing of risks and benefits in stakeholder engaged research is similar and different from other forms of research involving human ‘subjects.’ Drawing on HIV community-based research (CBR), we consider established risks, such as physical and emotional harms that may impact individual research participants as well as social harms that may impact individuals, organizations and coalitions, and entire communities. We consider how the active involvement of diverse stakeholders, with varying degrees of influence and power, can complicate traditional understandings of risks and benefits and raise questions about academic ethics and social justice.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Albarracin, D., & Jung, H. (2021). A research agenda for the post-COVID-19 world: Theory and research in social psychology. Asian Journal of Social Psychology, 24(1), 10–17. https://doi.org/10.1111/ajsp.12469

  • Biesma, R. G., Brugha, R., Harmer, A., Walsh, A., Spicer, N., & Walt, G. (2009). The effects of global health initiatives on country health systems: A review of the evidence from HIV/AIDS control. Health Policy and Planning, 24(4), 239–252. https://doi.org/10.1093/heapol/czp025

    Article  Google Scholar 

  • Boaz, A., Hanney, S., Borst, R., O’Shea, A., & Kok, M. (2018). How to engage stakeholders in research: Design principles to support improvement. Health Research Policy and Systems, 16(1), 60. https://doi.org/10.1186/s12961-018-0337-6

    Article  Google Scholar 

  • Brugge, D., & Kole, A. (2003). A case study of community-based participatory research ethics: The healthy public housing initiative. Science and Engineering Ethics, 9(4), 485–501.

    Article  Google Scholar 

  • Bungay, V., Oliffe, J., & Atchison, C. (2015). Addressing underrepresentation in sex work research: Reflections on designing a purposeful sampling strategy. Qualitative Health Research, 26(7), 966–978. https://doi.org/10.1177/1049732315613042

    Article  Google Scholar 

  • Bungay, V., Guta, A., Slemon, A., Varcoe, C., & Comber, S. (2022). The ethics of financial Incentivization for Health Research participation among sex Workers in a Canadian Context. Qualitative Health Research, 0(0), 10497323221089877. https://doi.org/10.1177/10497323221089877

    Article  Google Scholar 

  • Chakrapani, V., Newman, P. A., Singhal, N., Jerajani, J., & Shunmugam, M. (2012). Willingness to participate in HIV vaccine trials among men who have sex with men in Chennai and Mumbai, India: A social ecological approach. PLoS One, 7(12), e51080. https://doi.org/10.1371/journal.pone.0051080

    Article  Google Scholar 

  • Chakrapani, V., Newman, P. A., Sebastian, A., Rawat, S., Shunmugam, M., & Sellamuthu, P. (2021). The impact of COVID-19 on economic Well-being and health outcomes among transgender women in India. Transgender Health. https://doi.org/10.1089/trgh.2020.0131

  • Clark, T. (2008). `We're over-researched here!': Exploring accounts of research fatigue within qualitative research engagements. Sociology, 42(5), 953–970. https://doi.org/10.1177/0038038508094573

    Article  Google Scholar 

  • Collins, A. B., Strike, C., Guta, A., Turje, R. B., McDougall, P., Parashar, S., & McNeil, R. (2017). “We’re giving you something so we get something in return”: Perspectives on research participation and compensation among people living with HIV who use drugs. International Journal of Drug Policy, 39, 92–98. https://doi.org/10.1016/j.drugpo.2016.09.004

  • Council for International Organizations of Medical Sciences. (2017). International ethical guidelines for health-related research involving humans. World Health Organization.

    Google Scholar 

  • Damon, W., Callon, C., Wiebe, L., Small, W., Kerr, T., & McNeil, R. (2017). Community-based participatory research in a heavily researched inner city neighbourhood: Perspectives of people who use drugs on their experiences as peer researchers. Social Science & Medicine, 176, 85–92.

    Article  Google Scholar 

  • Ellis, C. (2016). Compassionate research: Interviewing and storytelling from a relational ethics of care. In The Routledge international handbook on narrative and life history (pp. 441–455). Routledge.

    Google Scholar 

  • Fry, C. L., Treloar, C., & Maher, L. (2005). Ethical challenges and responses in harm reduction research: Promoting applied communitarian ethics. Drug and Alcohol Review, 24(5), 449–459.

    Article  Google Scholar 

  • Gagnon, M., Guta, A., Upshur, R., Murray, S. J., & Bungay, V. (2020). "it gets people through the door": A qualitative case study of the use of incentives in the care of people at risk or living with HIV in British Columbia, Canada. BMC Medical Ethics, 21(1), 105. https://doi.org/10.1186/s12910-020-00548-5

    Article  Google Scholar 

  • Goodman, A., Morgan, R., Kuehlke, R., Kastor, S., Fleming, K., & Boyd, J. (2018). “We’ve been researched to death”: Exploring the research experiences of urban indigenous peoples in Vancouver, Canada. International Indigenous Policy Journal, 9(2).

    Google Scholar 

  • Grundy, J., & Smith, M. (2005). The politics of multiscalar citizenship: The case of lesbian and gay organizing in Canada. Citizenship Studies, 9(4), 389–404. https://doi.org/10.1080/13621020500211388

    Article  Google Scholar 

  • Guta, A., Wilson, M. G., Flicker, S., Travers, R., Mason, C., Wenyeve, G., & O'Campo, P. (2010). Are we asking the right questions? A review of Canadian REB practices in relation to community-based participatory research. Journal of Empirical Research on Human Research Ethics, 5(2), 35–46. https://doi.org/10.1525/jer.2010.5.2.35

    Article  Google Scholar 

  • Guta, A., Nixon, S. A., & Wilson, M. G. (2013). Resisting the seduction of "ethics creep": Using Foucault to surface complexity and contradiction in research ethics review. Social Science & Medicine, 98, 301–310. https://doi.org/10.1016/j.socscimed.2012.09.019

    Article  Google Scholar 

  • Guta, A., & Newman, P. A. (2021). Virality, desire and health assemblages: Mapping (dis)continuities in the response to and management of HIV and COVID-19. Culture, Health & Sexuality, 23(11), 1516–1531. https://doi.org/10.1080/13691058.2021.1981453

  • Guta, A., Flicker, S., & Roche, B. (2013). Governing through community allegiance: A qualitative examination of peer research in community-based participatory research. Critical Public Health, 23(4), 432–451. https://doi.org/10.1080/09581596.2012.761675

    Article  Google Scholar 

  • Guta, A., Strike, C., Flicker, S., Murray, S. J., Upshur, R., & Myers, T. (2014). Governing through community-based research: Lessons from the Canadian HIV research sector. Social Science & Medicine, 123, 250–261. https://doi.org/10.1016/j.socscimed.2014.07.028. https://www.sciencedirect.com/science/article/pii/S0277953614004572

    Article  Google Scholar 

  • Guta, A., Murray, S. J., & Gagnon, M. (2016a). HIV, viral suppression and new Technologies of Surveillance and Control. Body & Society, 22(2), 82–107. https://doi.org/10.1177/1357034x15624510

    Article  Google Scholar 

  • Guta, A., Murray, S. J., Strike, C., Flicker, S., Upshur, R., & Myers, T. (2016b). Governing well in community-based research: Lessons from Canada’s HIV research sector on ethics, publics and the Care of the Self. Public Health Ethics, 10(3), 315–328. https://doi.org/10.1093/phe/phw024

    Article  Google Scholar 

  • Harris, G. E. (2006). Practicing HIV/AIDS community-based research. AIDS Care, 18(7), 731–738.

    Article  Google Scholar 

  • Hassan, N. R., Swartz, L., Kagee, A., De Wet, A., Lesch, A., Kafaar, Z., & Newman, P. A. (2018). “There is not a safe space where they can find themselves to be free”: (un)safe spaces and the promotion of queer visibilities among township males who have sex with males (MSM) in Cape Town, South Africa. Health & Place, 49, 93–100. https://doi.org/10.1016/j.healthplace.2017.11.010

  • Horowitz, C. R., Robinson, M., & Seifer, S. (2009). Community-based participatory research from the margin to the mainstream: Are researchers prepared? Circulation, 119(19), 2633–2642.

    Article  Google Scholar 

  • Kazatchkine, M. (2014). TO PROTECT AND SERVE: How police, sex workers, and people who use drugs are joining forces to improve health and human rights.

    Google Scholar 

  • Kleitman, S., Fullerton, D. J., Zhang, L. M., Blanchard, M. D., Lee, J., Stankov, L., & Thompson, V. (2021). To comply or not comply? A latent profile analysis of behaviours and attitudes during the COVID-19 pandemic. PLoS One, 16(7), e0255268. https://doi.org/10.1371/journal.pone.0255268

    Article  Google Scholar 

  • Koen, J., Essack, Z., Slack, C., Lindegger, G., & Newman, P. A. (2013). 'It looks like you just want them when things get rough': Civil society perspectives on negative trial results and stakeholder engagement in HIV prevention trials. Developing World Bioethics, 13(3), 138–148. https://doi.org/10.1111/j.1471-8847.2012.00338.x

    Article  Google Scholar 

  • Koen, J., Wassenaar, D., & Mamotte, N. (2017). The ‘over-researched community’: An ethics analysis of stakeholder views at two south African HIV prevention research sites. Social Science & Medicine, 194, 1–9. https://doi.org/10.1016/j.socscimed.2017.10.005

  • Lee, J.-K., Bullen, C., Amor, Y. B., Bush, S. R., Colombo, F., Gaviria, A., Abdool, S. S., Karim, B. K., Lavis, J. N., Lazarus, J. V., Lo, Y.-C., Michie, S. F., Norheim, O. F., Juhwan, O., Reddy, K. S., Rostila, M., Sáenz, R., Smith, L. D. G., Thwaites, J. W., Were, M. K., & Xue, L. (2021). Institutional and behaviour-change interventions to support COVID-19 public health measures: A review by the lancet commission task force on public health measures to suppress the pandemic. International Health, 13(5), 399–409. https://doi.org/10.1093/inthealth/ihab022

    Article  Google Scholar 

  • Lewin, K. (1946). Action research and minority problems. Journal of Social Issues, 2(4), 34–46.

    Article  Google Scholar 

  • Lowman, J., & Palys, T. (2000). Ethics and institutional conflict of interest: The research confidentiality controversy at Simon Fraser University. Sociological Practice, 2(4), 245–264.

    Article  Google Scholar 

  • MacKinnon, K. R., Guta, A., Voronka, J., Pilling, M., Williams, C. C., Strike, C., & Ross, L. E. (2021). The political economy of peer research: Mapping the possibilities and Precarities of paying people for lived experience. The British Journal of Social Work. https://doi.org/10.1093/bjsw/bcaa241

  • Maguire, P. (1987). Doing participatory research: A feminist approach. University of Massachusetts Amherst.

    Google Scholar 

  • McClelland, A., Guta, A., & Greenspan, N. (2018). Governing participation: A critical analysis of international and Canadian texts promoting the greater involvement of people living with HIV & AIDS. Seeing Red: HIV/AIDS and Public Policy in Canada, 195–214.

    Google Scholar 

  • McFarlane, J., Soroya, A. O., Peng, W., Awonuga, O., & Morgan, S. E. (2021). Community-based participatory research (CBPR) to enhance participation of racial/ethnic minorities in clinical trials: A 10-year systematic review. Health Communication, 1-18. https://doi.org/10.1080/10410236.2021.1943978

  • McNeil, D. G. Jr. (2020). ‘We loved each other’: Fauci recalls Larry Kramer, friend and nemesis. The New York times, 2020. https://www.nytimes.com/2020/05/27/health/larry-kramer-anthony-fauci.html

  • Minkler, M. (2010). Linking science and policy through community-based participatory research to study and address health disparities. American Journal of Public Health, 100(S1), S81–S87.

    Article  Google Scholar 

  • Moen, K., Aggleton, P., Leshabari, M. T., & Middelthon, A.-L. (2012). Not at all so hard-to-reach: Same-sex attracted men in Dar Es Salaam. Culture, Health & Sexuality, 14(2), 195–208. https://doi.org/10.1080/13691058.2011.632825

    Article  Google Scholar 

  • Muhammad, M., Wallerstein, N., Sussman, A. L., Avila, M., Belone, L., & Duran, B. (2014). Reflections on researcher identity and power: The impact of positionality on community based participatory research (CBPR) processes and outcomes. Critical Sociology, 41(7–8), 1045–1063. https://doi.org/10.1177/0896920513516025

    Article  Google Scholar 

  • Murray, S. J., & Holmes, D. (2009). Critical interventions in the ethics of healthcare: Challenging the principle of autonomy in bioethics.

    Google Scholar 

  • Neufeld, S. D., Chapman, J., Crier, N., Marsh, S., McLeod, J., & Deane, L. A. (2019). Research 101: A process for developing local guidelines for ethical research in heavily researched communities. Harm Reduction Journal, 16(1), 41. https://doi.org/10.1186/s12954-019-0315-5

    Article  Google Scholar 

  • Newman, P. A. (2006). Towards a science of community engagement. Lancet, 367(9507), 302. https://doi.org/10.1016/s0140-6736(06)68067-7

    Article  Google Scholar 

  • Newman, P. A., & Guta, A. (2020). How to have sex in an epidemic Redux: Reinforcing HIV prevention in the COVID-19 pandemic. AIDS and Behavior, 24(8), 2260–2264. https://doi.org/10.1007/s10461-020-02940-z. https://www.ncbi.nlm.nih.gov/pubmed/32500463

    Article  Google Scholar 

  • Newman, P. A., Logie, C., James, L. L., Charles, T., Maxwell, J., Salam, K., & Woodford, M. (2011). “Speaking the dialect”: Understanding public discourse in the aftermath of an HIV vaccine trial shutdown. American Journal of Public Health, 101(9), 1749–1758. https://doi.org/10.2105/AJPH.2011.300208

    Article  Google Scholar 

  • Newman, P. A., Rubincam, C., Slack, C., Essack, Z., Chakrapani, V., Chuang, D. M., Tepjan, S., Shunmugam, M., Roungprakhon, S., Logie, C., Koen, J., & Lindegger, G. (2015). Towards a science of community stakeholder engagement in biomedical HIV prevention trials: An embedded four-country case study. PLoS One, 10(8), e0135937. https://doi.org/10.1371/journal.pone.0135937

    Article  Google Scholar 

  • Newman, P. A., Prabhu, S. M., Akkakanjanasupar, P., & Tepjan, S. (2021). HIV and mental health among young people in low-resource contexts in Southeast Asia: A qualitative investigation. Global Public Health, 1-15. https://doi.org/10.1080/17441692.2021.1924822

  • Newman, P. A., Reid, L., Tepjan, S., Fantus, S., Allan, K., Nyoni, T., Guta, A., & Williams, C. C. (2022). COVID-19 vaccine hesitancy among marginalized populations in the US and Canada: Protocol for a scoping review. PLoS One, 17(3), e0266120.

    Article  Google Scholar 

  • Palys, T., & MacAlister, D. (2016). Protecting research confidentiality via the Wigmore criteria: Some implications of parent and Bruckert v the Queen and Luka Rocco Magnotta. Canadian Journal of Law and Society/La Revue Canadienne Droit et Société, 31(3), 473–493.

    Article  Google Scholar 

  • Pantelic, M., Steinert, J. I., Ayala, G., Sprague, L., Chang, J., Thomas, R. M., Nininahazwe, C., Caswell, G., Bach-Mortensen, A. M., & Bourne, A. (2022). Addressing epistemic injustice in HIV research: A call for reporting guidelines on meaningful community engagement. Journal of the International AIDS Society, 25(1), e25880. https://doi.org/10.1002/jia2.25880

  • Pfeiffer, J., & Nichter, M. (2008). What can critical medical anthropology contribute to Global Health? A health systems perspective. Medical Anthropology Quarterly, 22(4), 410–415. http://www.jstor.org/stable/25487843

    Article  Google Scholar 

  • Philbin, M. M., Guta, A., Wurtz, H., Kinnard, E. N., Bradley-Perrin, I., & Goldsamt, L. (2021). How black and Latino young men who have sex with men in the United States experience and engage with eligibility criteria and recruitment practices: Implications for the sustainability of community-based research. Critical Public Health, 1-12. https://doi.org/10.1080/09581596.2021.1918329

  • Quinn, S. C. (2004). Ethics in public Health Research. American Journal of Public Health, 94(6), 918–922. https://doi.org/10.2105/AJPH.94.6.918

    Article  Google Scholar 

  • Rubincam, C., Lacombe-Duncan, A., & Newman, P. A. (2016). Taking culture seriously in biomedical HIV prevention trials: A meta-synthesis of qualitative studies. Expert Review of Vaccines, 15(3), 331–347. https://doi.org/10.1586/14760584.2016.1118349

    Article  Google Scholar 

  • Schnarch, B. (2004). Ownership, control, access, and possession (OCAP) or self-determination applied to research: A critical analysis of contemporary first nations research and some options for first nations communities. International Journal of Indigenous Health, 1(1), 80–95.

    Google Scholar 

  • Slack, C., Thabethe, S., Lindegger, G., Matandika, L., Newman, P. A., Kerr, P., Wassenaar, D., Roux, S., & Bekker, L. G. (2016). I've gone through this my own self, so i practice what i preach. Journal of Empirical Research on Human Research Ethics, 11(4), 322–333. https://doi.org/10.1177/1556264616675202

    Article  Google Scholar 

  • Strike, C., Guta, A., de Prinse, K., Switzer, S., & Carusone, S. C. (2014). Living with addiction: The perspectives of drug using and non-using individuals about sharing space in a hospital setting. International Journal of Drug Policy, 25(3), 640–649. https://doi.org/10.1016/j.drugpo.2014.02.012

  • Strike, C., Guta, A., De Prinse, K., Switzer, S., & Carusone, S. C. (2016). Opportunities, challenges and ethical issues associated with conducting community-based participatory research in a hospital setting. Research Ethics, 12(3), 149–157.

    Article  Google Scholar 

  • Switzer, S, Adrian Guta, de K Prinse, S Chan Carusone, C Strike. 2015. "Visualizing harm reduction: Methodological and ethical considerations." Social Science & Medicine 133: 77–84.

    Google Scholar 

  • Travers, R., Wilson, M. G., Flicker, S., Guta, A., Bereket, T., McKay, C., van der Meulen, A., Cleverly, S., Dickie, M., & Globerman, J. (2008). The greater involvement of people living with AIDS principle: Theory versus practice in Ontario's HIV/AIDS community-based research sector. AIDS Care, 20(6), 615–624.

    Article  Google Scholar 

  • Travers, R., Pyne, J., Bauer, G., Munro, L., Giambrone, B., Hammond, R., & Scanlon, K. (2013). ‘Community control’ in CBPR: Challenges experienced and questions raised from the trans PULSE project. Action Research, 11(4), 403–422. https://doi.org/10.1177/1476750313507093

    Article  Google Scholar 

  • Troiano, G., & Nardi, A. (2021). Vaccine hesitancy in the era of COVID-19. Public Health, 194, 245–251. https://doi.org/10.1016/j.puhe.2021.02.025

  • Tufford, L., Newman, P. A., Brennan, D. J., Craig, S. L., & Woodford, M. R. (2012). Conducting research with lesbian, gay, and bisexual populations: Navigating research ethics board reviews. Journal of Gay & Lesbian Social Services, 24(3), 221–240. https://doi.org/10.1080/10538720.2012.697039

    Article  Google Scholar 

  • UNAIDS. 2021. Ethical considerations in HIV prevention trials.

    Google Scholar 

  • Upshaw, T. L., Brown, C., Smith, R., Perri, M., Ziegler, C., & Pinto, A. D. (2021). Social determinants of COVID-19 incidence and outcomes: A rapid review. PLoS One, 16(3), e0248336. https://doi.org/10.1371/journal.pone.0248336

    Article  Google Scholar 

  • Vasan, S., & Pitisuttithum, P. (2021). Vaccine development lessons between HIV and COVID-19. The Lancet Infectious Diseases, 21(6), 759–761. https://doi.org/10.1016/S1473-3099(21)00274-7

    Article  Google Scholar 

  • Wenzel, A., Gerson, D., Moreno, E., Son, M., & Hawkins, B. M. (2017). Engaging stigmatized communities through solutions journalism: Residents of South Los Angeles respond. Journalism, 19(5), 649–667. https://doi.org/10.1177/1464884917703125

    Article  Google Scholar 

  • Williams, J., Brinton, M., & Lykes. (2003). Bridging theory and practice: Using reflexive cycles in feminist participatory action research. Feminism & Psychology, 13(3), 287–294.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Adrian Guta .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Guta, A., Newman, P.A., Bourne, A. (2023). Rethinking Risks and Benefits in Stakeholder-Engaged Research: Lessons from HIV, Substance Use, and Sexual Health Research with Marginalized Communities. In: Anderson, E.E. (eds) Ethical Issues in Community and Patient Stakeholder–Engaged Health Research. Philosophy and Medicine, vol 146. Springer, Cham. https://doi.org/10.1007/978-3-031-40379-8_15

Download citation

Publish with us

Policies and ethics