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The Essential Need for Trust When Transmission Risk Cannot Be Eliminated in HIV-Remission Trials.

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Analytic treatment interruption (ATI) in HIV remission studies is necessary but risky. Building trust and trustworthiness is essential for the ethical and successful conduct of these trials, as transmission risks cannot be fully eliminated.

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Area of Science:

  • HIV/AIDS research
  • Clinical trial ethics
  • Infectious disease management

Background:

  • Analytic treatment interruption (ATI) is crucial for evaluating HIV remission strategies.
  • Stopping antiretroviral therapy during ATI presents risks of HIV transmission to participants and partners.
  • Current ethical discussions focus on risk mitigation and stakeholder responsibilities.

Purpose of the Study:

  • To examine the ethical complexities of ATI in HIV remission trials.
  • To explore the role of trust and trustworthiness in managing ineliminable transmission risks.
  • To analyze the strengths and limitations of risk-mitigation and responsibility frameworks.

Main Methods:

  • Qualitative analysis of experiences from HIV remission trials involving ATI in Thailand.
  • Examination of ethical debates surrounding risk mitigation and participant safety.
  • Exploration of trust-based approaches in clinical research settings.

Main Results:

  • The possibility of HIV transmission during ATI is practically ineliminable.
  • Risk-mitigation and responsibility approaches have inherent complexities and limitations.
  • Trust and trustworthiness are vital for enhancing the scientific, practical, and ethical conduct of ATI trials.

Conclusions:

  • Successful HIV remission trials with ATI depend fundamentally on establishing trust and trustworthiness.
  • Ethical conduct requires acknowledging and managing ineliminable risks through strong relational foundations.
  • Future research should prioritize building and maintaining trust in sensitive clinical trials.