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Free Content Integrating research into routine service delivery in an antiretroviral treatment programme: lessons learnt from a cluster randomized trial comparing strategies of HIV care in Jinja, Uganda

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Summary Trials integrated into normal health service delivery are designed to evaluate the effectiveness of interventions under real-life conditions. However, integrating research into service delivery creates many operational challenges and raises ethical dilemmas. Here we discuss the operational and ethical issues arising from such trials using the example of a cluster randomized trial evaluating two strategies of ART delivery in Jinja, south-east Uganda.

Intégration de la recherche dans la prestation de routine des services dans un programme de traitement antirétroviral: leçons tirés d’un essai randomisé en grappes comparant les stratégies de prise en charge du VIH à Jinja, en Ouganda

Les études intégrées dans la prestation normale des services de santé sont conçues pour évaluer l’efficacité des interventions en conditions réelles. Cependant, l’intégration de la recherche dans la prestation des services crée de nombreuses difficultés opérationnelles et pose des défis éthiques. Ici, nous discutons des questions éthiques et opérationnelles découlant de ces essais en utilisant l’exemple d’un essai randomisé en grappes pour l’évaluation de deux stratégies de délivrance de l’ART à Jinja, dans le sud-est de l’Ouganda.

Keywords: Ensayo aleatorizado en grupos; HIV/AIDS; Uganda; antiretroviral; desafíos en investigación; défis de la recherche; effectiveness; efficacité de l’essai; ensayo de efectividad; essai randomisé en grappes; health services research; services de santé de l’Ouganda; servicios sanitarios; terapia antirretroviral; thérapie antirétrovirale

Document Type: Research Article


Affiliations: 1:  Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK 2:  MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda 3:  The AIDS Support Organisation, Kampala, Uganda

Publication date: 2008-06-01

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