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Case Three – Conducting Research on men who have sex with men (MSM) and HIV in Africa Material for this case study was taken from: Amon JJ, Baral SD, Beyrer C, Kass N (2012) Human Rights Research and Ethics Review: Protecting Individuals or Protecting the State? PLoS Med 9(10): e1001325. doi:10.1371/journal.pmed.1001325   In recent years, we have seen significant growth in the number of research studies conducted in low and middle income countries.  Correlating with this increase has been a growing number of research ethics committees (RECs) in these countries.  Unfortunately, many of these research ethics committees are under the influence of the state.  The state may be more concerned about their interests over the interests of research participants.  This has an impact on the kind of research allowed. You are a member of a research team conducting a multi-country study on HIV amongst men who have sex with men in Africa.  The governments of some of the countries your team has selected are opposed to the research.  They deny that homosexuality exists in their countries, and they do not want to support research that would lend validation to this idea or the fact the MSM are at greater risk for HIV infection. At one site of the multi-country study, the head of the only university-based institutional review board told your team that since homosexuality was criminalized in the country, no research protocols related to MSM would be considered for review. The team has met with leaders and members of community based organizations to assess interest levels in the research.  Team members trained community leaders on research ethics.  The team has concluded that interest is high, and participants are readily available and eager. What are the ethical issues?  Would you continue with the research as a member of this team? If so, what steps might you take to ensure the rights of participants are protected?

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