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Topic
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Read this hypothetical scenario and respond….
Imagine that you are conducting a study among MSM in a community where homosexuality is highly stigmatized and is illegal in the country. Some of your participants are attacked at a local nightclub because rumors have circulated about their involvement with the site, which has become known as a ‘place where people train to become gay’.
How would your team or site handle this situation?
What could possibly have been done in advance to try to avoid this occurrence?
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Replies
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Safety first. First to place a call to any of the members and find out about their safety. The PI should be informed to immediately convene CAB at a secured place to initiate the process of investigation and issue management planing.
Most often the staff at the facility are also at risk so safety SOP need to implemented immediately with security doors at the entrance.
Before starting the study, the team is suppose to do community mapping and establish code of conduct in public places to avoid unnecessary attraction.
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Hi Anne,
In this case, the team would need to refer to the issues management plan to see how best to deal with the situation. Prior to trial implementation, the site is required to compile an issues management plan where they can anticipate such problems in the trial and draw up strategies to deal with such situations.
The site could’ve worked with local MSM groups and educated the community about the upcoming trial. The site could’ve also worked with advocacy groups and human rights groups and strategized a community event to educate and inform the community about the upcoming trial and the work that is done at the site.
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This is a challenging situation,
However i think before conducting the study, the research team and especially the community outreach team should have conducted a focus group discussion with the MSM and other advocacy group members to understand their views and what are the threats around their practices , and what is to expect if they participate in the trial. together they will discuss on strategies to mitigate the harms if/when they happen, since they are the main stake holders in this case.
Additionally is important to engage other authorities /bodies working with human rights and other activists, using information from these discussion the research team should develop a site management plan for the trial.
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Communication with MSM stakeholder groups would be essential before intiating any part of the trial. This could have helped map out potential problems and brainstorm ways to avoid or alleviat these.
If possible, discussion with more formals agencies (e.g., police, legal representatives) may help in planning for any potential issues.
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This is indeed a complex scenario. The fact that MSM is illegal makes it very difficult even to conduct the research. Now that this research has been given a go ahead there is need to look at who are influential in the site were the research is going to take place. After identifying these people it will be good to use them to mitigate some of the anticipated risks that the trial participants may face. This is not an easy one but definitely some solution should be found to ensure that participants are as much as possible protected.
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Being illegal. The community and media will need to be informed regarding the trial.
Regarding the trial protocol there should be measure taken to protect the participants.
Regarding the incident, local healthcare providers should be contacted,
The media should be made aware and a statement should be out.
To prevent reoccurrence more awareness should be made to the media
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the site will need to work with the CAB to brainstroms on ways the current situatioin can be adrresed , and then meet the study participants at individaual and group level to understand and find ways in which the situatiions can be erectified. Community eduaction needs to be done to increase the research competency of the communities involved. Representives from the concerned community can also be invited for discusions that can center around the research and participation
Stake holders could have first been enganged and discusions on the potential harms and developments that can arise as the study starts, stake holders can take part in developing key messages for the communities on the study trail that could help the community understand what the research trails involves . The site would develop and issuse management plan on how these circumstances would be addressed
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<span style=”line-height: 1.5em;”>1. The research team would have meeting with the CAB and a also implement the issue management plan. Work with the Human right advocate who is a member of the CAB on the best way that has been agreed to handle the issue.</span>
2. During the planning stage trial site should be assessed. Key opinion leader in that community should be engaged as well as MSM union leaders. They can discussion all the social harm that the group potential harm and the way the community perceive some social issues. Based on that the issue management plan should be developed with the inputs of these community stakeholder. A member of the Law enforcement agency should be a member of the CAB, they would handle any gender violence with advocacy group.
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With the GPP guidelines , there was to be a proper mapping of the stakeholders, in this case including the Club owners and have an idea of the common social harms that occur in relation to the MSMs. By so doing issues management plan would be put in place to address the issue.
In most cases the fellow study participants will show up regardless of their schedule visits to share the matter. The PI/study coordinator will inform the CAB members who will together with the research team investigate the matter and address the situation accordingly.
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Upon receiving the report of this incident of social harm related to study participation, my first line of action is to notify the PI and study team. Next I will call CAB members and other relevant stakeholders so that we can consult and come up with a communication and issues management plan to address and mitigate the issue and explore of preventing recurrence of the same.
What could have done earlier.
GPP was not implemented before the trial commenced, apparently the team had not done proper mapping to understand the sociocultural landscape, because what mattered and cause concern to the community could have been found out. When a research study seem to challenge community norms, a back lash should be anticipated, and a communication and issues management plan developed in consultation with relevant stake holders to prevent the crisis.
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Inviting all trial participants in small groups to address the issue because once the rumours are spread fewer participants will attend their schedule visits. Involving the stakeholders and the media might also be solution because the word is spread easily by means of communication but that will be possible only if the sponsor agrees. Conducting community events in areas that we suspect have a little knowledge of the research and are against the research.
In the beginning of the study, research team was suppose to do research about the community and find out what might be the issues regarding the trial and come up with issues management plan. Targeting areas that most participants are coming from or where they spend most of their time, places like nightclubs and even include people from those areas in the community advisory board.
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Involve CAB and other key stakeholders including participants to assess the attitudes and perceptions of community members.
Identify possible strategies for addressing the concerns of community which also protect the study participants.
However in the earlier stages of trial, formative research activities had to be done to ensure that the community is understood and well represented on the CAB,.
Stakeholder engagement had to be done to understand possible sources of conflicts through consultative meetings with stakeholders and strategies to mitigate these risks in an issues management plan.
Community sensitization and involvement through meetings and protocol reviews minimizes such risks.
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Before the start of the study the research team was supposed to work closely with relevant stakeholders to identify and plan for such risks and come up with a solution. This is why there is a need to have an Issues management plan. By developing this plan prior to trial implementation,the research team will be better equipped to deal with such issues.
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The team will need to assess the safety of all trial participants and ensure that everyone is aware of the rumour and potential impact on their safety. The team must then develop an issues management plan to address the rumour with support and input from the key stakeholders and community by discussing the study, explain the concept of being gay and that it is not to be denied among the community members. Researchers may engage with advocates and alert the local police of potential violence linked to the research population group.
The researchers should have developed a better understanding of the community and their views and responses to the research among the gay or MSM population. Sensitization and education efforts on MSM should have been implemented and assessed so that the researchers appreciate the cultural and social factors impacting on the project goals. The security and safety of the participants in context of stigma should have been discussed and the team needed to develop a plan prior to study start up.
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Hi Anne,
First before you conduct the study in any site, you have to have your community knowledge through the Stakeholders you have selected to work with to just run a simple but easy survey about the acceptability of the MSM group in the community. After that you will now plan who to involve to protect the group recruited, like educating the community why you have chosen that particular study, how vulnerable and high risk. Invite human rights organisations, the politicians, gender violence groups. Organise community events to educate the communities.
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<strong style=”line-height: 1.5em;”>How would your team or site handle this situation?
- we will look for activist organisation that work with MSM
- we will explain the purpose of the study and partner with them for community education
- we will also conduct workshops together with the for our CAG and do gender sensitization
- we will also try to have pear educators from MSM
What could possibly have been done in advance to try to avoid this occurrence?
- you will need to operate as MSM do to avoid confrontation by community members who are not informed
- learn from MSM community how they survive acts of the community
- engage gatekeepers and identify leaders that are able to protect MSM
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