Exploring the Ethical Landscape of HIV Phylogenetics: My Journey at Ethox

Francisca Faber, visiting student from Vrije Universiteit of Amsterdam

In March 2024, I had the privilege of visiting the Ethox department as a Master’s student of Philosophy, Bioethics, and Health at the Vrije Universiteit of Amsterdam. During my visit, I delved into the ethical intricacies surrounding the use of phylogenetic techniques in HIV molecular surveillance.

Transitioning from the traditional confines of lecture halls and exams to the collaborative atmosphere of a research department was a very welcome transition for me. It allowed me to apply my studies and work on a specific research project.

In my time at Ethox I conducted a risk-benefit analysis of individuals that can be identified as being involved in multiple HIV transmission events with phylogenetics. HIV phylogenetics is a technique that can assess relations between different individuals’ HIV genomes, combining this information with other data sources (such as personal identifying and medical data), enables public health authorities to get increasing insights into transmission patterns of who might have infected whom.

The use of phylogenetics in molecular surveillance holds the potential for elucidating transmission patterns and can potentially offer benefits in preventing HIV transmission and increasing HIV care. However, this progress also raises significant ethical dilemmas, particularly concerning privacy, trust, criminalization, and the potential for stigmatization within at-risk or HIV-positive populations. In my project, these different benefits and risks were analyzed from the perspective of the individuals that can potentially be identified by this new technique.

It was very interesting to work on such a current and pressing issue. The technique is already employed as a surveillance practice in some countries around the world, and its use is increasing. Drawing from my background in virology, which involved extensive lab work and experiments, provided valuable insights into the intersection of technological advancement and ethical consideration. It was intriguing to consider the broader implications of this technique for public health and molecular surveillance.

My time at Ethox was not only intellectually stimulating but also profoundly motivating. Engaging in discussions, sharing ideas, and collaborating with the team fueled my passion for bioethics and underscored the importance of the work. I will keep working on the topic of HIV phylogenetics and make it a central topic of my thesis in the final phases of my Master’s study.

I am thankful for the great guidance and mentorship provided by my supervisor, Euzebiusz Jamrozik, whose expertise and support were instrumental in shaping my research experience. Moreover, the warm welcome extended by the entire Ethox team enriched my time at the center, and it was great to get a peek into their team.

Beyond the academic pursuits, I also had a wonderful time exploring the beauty of the city of Oxford. I don’t think I have ever seen more books and drank more coffee in picturesque coffee shops than in this month! I will definitely remember Oxford as it has made a great impression on me.

In retrospect, my visit to Ethox was a very educational journey that deepened my understanding of the ethical complexities involved in employing HIV phylogenetics in surveillance practices. I am eager to carry forward the insights gained during my project and would like to extend my thanks to the whole Ethox team for making this experience as memorable as it was!