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Towards a Science of Community Engagement in Biomedical HIV Prevention Trials: An Embedded Multiple Case Study in Canada, India, South Africa and ThailandNewman PA, Rubincam CC, Chuang D-M, Lindegger G, Slack C, Chakrapani V, Shunmugam M, Tepjan S, Roungprakhon S, & Canadian HIV Vaccine Initiative Team Background • Community stakeholder engagement (SE) is foundational to fair & ethically conducted biomedical HIV prevention trials • Scant empirical research has addressed SE • To identify cross-cutting & site specific challenges & facilitators of SE in global HIV prevention trials Methods • From 2009-2012 we conducted an embedded exploratory case study with a multiple case design (n=235)
Multiple Case Study Design • Ensuring trial literacy • Addressing mistrust • Processes of meaningfulstakeholder engagement • Bangkok, Thailand • Chennai, India • Durban, S. Africa • Toronto, Canada Subsystems New Conception of Cases Cases CSO representatives Community leaders & advocates Community members Former trial participants Service providers Clinical trialists Decomposition Synthesis
Conclusions • Trial literacy: Ensure understanding among community stakeholders of complex trial concepts • Historically-based mistrust among local communities • Ethical integrity: explore how trials can best meet ethical obligations (e.g. ancillary services, post-trial care) • Clear & transparent communication between researchers & trial participants • Autonomy & independent decision-makingof CABs/CBOs must be balanced with need for training & support