Professor Jerome Singh.

Both young and seasoned researchers from the College of Health Sciences (CHS) attended a presentation at a Women in Leadership and Leverage Committee (WILL) workshop by Professor Jerome Singh, Head of Ethics and Law at the Centre for the AIDS Programme of Research in South Africa (CAPRISA).

Singh, who spoke on current issues in medical ethics, told the audience about the consequences of being insensitive to sex and gender issues in the “concept and conduct” of research. He said a valuable opportunity was lost when researchers did not ask the right type of questions in studies that could result in policy changes.

‘If you are doing research you have a moral obligation and a scientific obligation to ensure that you ask relevant questions, and that your relevant questions have social value in the context in which they are asked.’

Singh said one of the major challenges was that when research was being designed, and studies taken into account, participants were usually not considered from the gendered perspective. ‘In other words we look at a generic research question.’

He said issues of sex and gender should be considered in not only the conception, design and implementation processes, but also in terms of policies as well as it saved time and money, in addition to improving the efficacy of policies implemented at the end of a study.

Singh explained that if researchers were not sensitive about who they are enrolling in the study the results of the study were not as widely applicable as they could have been. ‘You must consider whether there are sex issues or gender issues implicit in the research question.’

His presentation questioned how effective it was to promote medical male circumcision (MMC) for HIV prevention in young men if the potential risks and benefits explained during the counselling process were not gendered.

He explained that the efficacy of MMC in preventing HIV was based on a study done on heterosexual males and not men who have sex with men (MSM). He said the risk profile of the latter group, bisexual men and men who have sex with multiple and concurrent partners needed to be discussed with all males who volunteer for MMC.

Singh said it was equally important to consider whether policies should be implemented the same way for men and women, boys and girls, young girls in puberty and for women undergoing menopause.

He elaborated on how individuals infected with HIV were surviving longer, especially with the introduction of antiretroviral treatment. ‘What we have still not found out is how, for example, antiretroviral drugs impact on menopause. Women who were infected in their late thirties and forties, 15 years ago are now reaching menopause, and there’s still insufficient questions that have been asked in terms of how menopause impacts on drug absorption, and how drug absorption impacts on menopause.’

Singh said there were ethical and regulatory barriers preventing the enrolment of young girls into studies whilst teenage girls were at high risk of contracting HIV. He said it was important to understand whether drug absorption levels changed at menopause, puberty and during monthly menstruation. ‘How does the onset of puberty impact on the absorption of drugs, and on the impact of the drug on the system?’

Singh encouraged those in the audience to consider whether their research could have different implications for men and women. ‘You can be classified male or female biologically, but your sense of self is what your gender is.’

Singh suggested the following for researchers: ‘Ask yourself whether it is due to gendered reasons that your participants dropped out of a study. Should you be designing your study to find out those finer nuances between sex and gender, and will the results be generalizable to the rest of the population you are engaging with?’