HIV phylogenetic and molecular epidemiology analyses are increasingly being performed with a goal of improving HIV prevention efforts. However, ethical, legal and social issues are associated with these analyses, and should be considered when performed.
Several working groups have recently outlined the major issues surrounding the use of molecular epidemiology for HIV prevention. First, the benefits of HIV molecular epidemiology remain unclear, and further work is needed to quantitatively demonstrate the benefits that can be expected. Second, privacy loss is an important risk, with implications of disclosure varying by the regional legal and social climate. Inferential privacy risks will increase with technological improvements in sequencing and analysis. Third, data sharing, which enhances the utility of the data, may also increase the risk of inferential privacy loss. Mitigation strategies are available to address each of these issues.
HIV molecular epidemiology for research and public health pose significant ethical issues that continue to evolve with improving technology, increased sampling and a changing legal and social climate. Guidance surrounding these issues needs to be developed for researchers and public health officials in an iterative and region specific manner that accounts for the potential benefits and risks of this technology.
aDepartments of Medicine and Pathology, University of California San Diego
bDepartment of Medicine San Diego Veterans Affairs Medical Center
cDepartment of Psychiatry, University of California San Diego
dDepartment of Medicine, University of California San Diego, San Diego, California, USA
Correspondence to Sanjay R. Mehta, MD, Departments of Medicine and Pathology, University of California San Diego, 9500 Gilman Drive MC 8208, San Diego, CA 92093, USA. Tel: +1 858 642 3175; fax: +1 619 543 5094; e-mail: firstname.lastname@example.org