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. 2019 Aug;26(5):1540-1553.
doi: 10.1177/0969733017753743. Epub 2018 Mar 7.

A qualitative description of service providers' experiences of ethical issues in HIV care

Motshedisi B Sabone  1 , Keitshokile Dintle Mogobe  1 , Ellah Matshediso  2 , Sheila Shaibu  1 , Esther I Ntsayagae  1 , Inge B Corless  3 , Yvette P Cuca  4 , William L Holzemer  5 , Carol Dawson-Rose  4 , Solymar S Soliz Baez  6 , Marta Rivero-Mendz  6 , Allison R Webel  7 , Lucille Sanzero Eller  5 , Paula Reid  8 , Mallory O Johnson  4 , Jeanne Kemppainen  8 , Darcel Reyes  9 , Kathleen Nokes  10 , Dean Wantland  5 , Patrice K Nicholas  3 , Teri Lingren  5 , Carmen J Portillo  11 , Elizabeth Sefcik  12 , Ellen Long-Middleton  13
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A qualitative description of service providers' experiences of ethical issues in HIV care

Motshedisi B Sabone et al. Nurs Ethics. 2019 Aug.

Abstract

Background: Managing HIV treatment is a complex multi-dimensional task because of a combination of factors such as stigma and discrimination of some populations who frequently get infected with HIV. In addition, patient-provider encounters have become increasingly multicultural, making effective communication and provision of ethically sound care a challenge.

Purpose: This article explores ethical issues that health service providers in the United States and Botswana encountered in their interaction with patients in HIV care.

Research design: A descriptive qualitative design was used to collect data from health service providers and patients using focused group discussions. This article is based on responses from health service providers only.

Participants and context: This article is based on 11 focused group discussions with a total sample of 71 service providers in seven US sites and one Botswana site.

Ethical considerations: Ethical review boards at all the study sites reviewed the study protocol and approved it. Ethical review boards of the study's coordinating centers, Rutgers University and the University of California at San Francisco, also approved it. The study participants provided a written informed consent to participate.

Findings: HIV service providers encountered ethical challenges in all the four Beauchamp and Childress' biomedical ethics of respect for patients' autonomy, beneficence, justice, and nonmaleficence.

Discussion: The finding that HIV service providers encounter ethical challenges in their interaction with patients is supported by prior studies. The ethical challenges are particularly prominent in multicultural care and resource-constrained care environments.

Conclusion: Provision of HIV care is fraught with ethical challenges that tend to pose different issues depending on a given care environment. It is important that strong partnerships are developed among key stakeholders in HIV care. In addition, health service providers need to be provided with resources so they can provide quality and ethically sound care.

Keywords: Clinical ethics; confidentiality; ethics of care/care ethics; professional ethics; qualitative research.

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Conflict of interest statement

Conflict of interest

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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