Ethical Practices in HIV Research During Humanitarian Crises

This study examined how published HIV acquisition research conducted in humanitarian crisis settings reports ethical principles and practices. The researchers focused on studies involving people affected by crises such as armed conflict, displacement, and natural disasters. They assessed whether these studies described key ethical practices, including ethics review, informed consent, confidentiality, participant protection, compensation, community engagement, funding, conflict of interest disclosure, authorship affiliation, open access publication, and journal ethics requirements.

HIV research in humanitarian crises often involves people who may face displacement, insecurity, stigma, poverty, trauma, sexual violence, or limited access to health services. These conditions can increase both HIV-related vulnerability and the ethical complexity of conducting research. Clear ethical practices are essential to protect participants, build trust, support community engagement, and ensure that research benefits the people and communities most affected by humanitarian crises.

The researchers conducted an exploratory cross-sectional analysis of 41 peer-reviewed studies identified through a prior scoping review on HIV acquisition in humanitarian crises. The included studies were published between 1990 and 2022 and reported empirical data on HIV prevalence, incidence, or risk factors among people affected by humanitarian crises. The research team reviewed each article to determine whether and how it reported ten key ethical principles and practices relevant to humanitarian health research and equitable global health partnerships.

Most studies reported ethics review and approval, informed consent, funding sources, and at least some local or in-country author affiliation. However, reporting was less consistent in several important areas. Some studies did not clearly report confidentiality or participant protection measures, and many did not mention participant compensation. Reporting on community engagement and cultural considerations was also variable. Conflict of interest statements and open access publication were inconsistently reported. Although most studies conducted in low- and middle-income countries included some local collaboration, first and senior authorship were often held by researchers affiliated with high-income country institutions.

The findings show the need for stronger and more consistent ethical reporting in HIV research conducted during humanitarian crises. Researchers should use standardized approaches for informed consent, confidentiality, participant protection, compensation, community engagement, conflict of interest disclosure, and authorship equity. Journals and ethics review committees can also play an important role by requiring clearer reporting of ethical safeguards and encouraging practices that promote equitable partnerships with local researchers and affected communities.

Future work should focus on developing practical ethics frameworks for HIV and other health research in humanitarian settings. These frameworks should help researchers and ethics review committees address the specific challenges of conducting research with crisis-affected populations, including power imbalances, participant vulnerability, community engagement, compensation, confidentiality, and equitable authorship. The study also suggests that journals should more rigorously require ethical reporting standards for research conducted in humanitarian contexts.

This research was supported by Yale University School of Public Health and Yale University School of Medicine. This work was also supported by the Kempf grant from the Whitney and Betty MacMillan Center for International and Area Studies at Yale University, awarded to Kaveh Khoshnood and J. Lucian Davis. J. Lucian Davis, Dina Garmroudi, Dini Harsono, and Kaveh Khoshnood were supported by grant P30MH062294 from the National Institute of Mental Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Whitney and Betty MacMillan Center for International and Area Studies at Yale University or the National Institute of Mental Health.