Ethical Considerations and Responsibilities in the Planning and Implementation of a Study on Infectious Diseases Among People Experiencing Homelessness in Berlin, Germany

Author: Navina Sarma Gyde Steffen Caoimhe Cawley Astrid Leicht Christoph Weber Sascha Heidrich Katja Kajikhina Claudia Hövener Klaus Jansen Stefan Kröger Ruth Zimmermann Viviane Bremer Klaus

Theme: Epidemiology & Public Health Research Year: 2022

Poor access to measures of harm reduction and safer sex, imprisonment and origin from high
prevalence countries can increase the risk for HIV and viral Hepatitis among people experiencing
homelessness (PEH). Valid data as basis for targeted prevention and care in Germany is needed.
Therefore, a multicentre cross-sectional sero-behavioural study (POINT-study) among PEH was
piloted in Berlin in 2021. As research, apart from its goal to understanding and improving health,
also has the potential to cause additional harm to stigmatised and marginalised populations such as
PEH and drug users, ethical aspects are the focus of this presentation.
The interdisciplinary study team with actors from harm reduction and homeless services,
epidemiological research and infectiology enabled awareness from different perspectives
throughout the study. Central components of the study were point-of-care-screening, linkage-tocare, language mediation, incentives for respondents and a questionnaire that included questions on
the living and working situation of respondents. Study participants were included in the evaluation.
Research results were discussed with low threshold service providers to identify practical
The response was high with all together 216 participants. During evaluation we learned that
participants appreciated the free-of-cost test offer, linkage-to-care, available language mediation,
incentives and the pleasant and respectful atmosphere during data collection. The need for
improvement of awareness about HIV and Hepatitis within homeless services, as well as a closer
cooperation between homeless services, harm reduction services and infectiology was identified.
The study is a step towards better data and direct transfer of research results into practice which
enables targeted prevention, access to diagnostic, treatment and care for PEH without reproducing
stigma and social exclusion. With this presentation we aim to discuss ethical pitfalls with conference
attendees in order to learn and implement learnings in an adapted study design as part of a national
Disclosure of Interest Statement:
The conference collaborators recognise the considerable contribution that industry partners make to
professional and research activities. We also recognise the need for transparency of disclosure of
potential conflicts of interest by acknowledging these relationships in publications and presentations.

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