Compo, Shepherd Kate

Orlanda, Maria Poinsithia

Salimbagat, Christine

BSN III - CCC

Week 10: Research Group Activity

Case Study 1. Respect for Persons

Sexually Transmitted Infections among Commercial Sex Workers

Source: FHI 360

A Ministry of Health has requested a prevalence/behavioral surveillance study for sexually

transmitted infection (STI) among commercial sex workers. Participants in this study will be
tested for three common STIs and will participate in an interview. Participants will receive a card
with a number linking them to their blood sample and will have the option of presenting their
cards to get the results of the STI tests. Those with positive results for any of the three infections
will be offered free treatment. In addition, all participants will receive a small gift in return for
their participation.

The target population consists of brothel-based sex workers who are strictly controlled by the
brothel managers. Prior to initiating the research, a researcher meets with the brothel manager to
ask permission to conduct the study. During the meeting, the manager states that all of the
women working in the brothel will participate in the study.

Questions

1. What steps can the researchers take to ensure that informed consent is freely given by all
participants?

Remember that only after receiving and understanding all the information especially in a
language or manner they could easily grasp prior to any voluntary decision made related to
sexually transmitted infection (STI) prevalence/behavioral surveillance study, the target
population of brothel-based sex workers can then provide their willingness to participate in this
trial. Now, the researchers involved in this study must work and ensure to provide education to
the brothel manager emphasizing the information that nonparticipation is acceptable and is
actually a choice he could make, which might also help him have a relaxed attitude. Meanwhile,
the process of getting the informed consent must happen in a private setting ensuring
confidentiality to the potential participants. The target population brothel-based sex workers
must be as well reminded frequently of the nature of the study being a voluntary one and refusal
of participation must be known as one of the options.
2. If a woman chooses not to participate in the study, what can be done to protect her from
retaliation by the manager?

Because their manager states that all of the women working in the brothel will participate
in the study, it will be vitally important that nonparticipants remain anonymous. Informed
consent is given individually, and not the employer gets to decide who should undergo but it is
still a must for the researchers to ask permission to their manager to prevent future conflicts.
Permissions and approval are used to communicate and verify the cooperation. It is time-
consuming because it has to be done in a deductive way, from general to specific or from
employer to employee. Peer pressure is common nowadays, that’s why obtaining informed
consent must be performed separately and discretely.

3. If you believe that the women will not be able to give voluntary informed consent, what
alternatives could you suggest to the Ministry of Health?

The participants have an expression of choice which means they have the ability to make
and express a clear decision about whether to participate-- they can withdraw from the study at any
time or choose not to participate. If the target population will not be able to consent freely, then you
are obligated to change the study or choose a different target population. For example,
commercial sex workers who are not brothel-based might not face pressure from a manager that
would alter their decision.