Establishing a New Research Agenda Regarding Population Health Ethics and Young People's Health

The Internet is a medium that offers unprecedented reach to populations at risk for STIs/HIV. Youth (ages 15-24) bear a significant burden of STI/HIV infection, particularly in some communities (e.g. rural, with large youth populations), and have been shown to be particularly receptive to internet-based services. The STI/HIV Division at BC Centre for Disease Control (BCCDC) has recently developed GetCheckedBC (GCBC), a new online STI/HIV testing intervention. Youth are important target clients for the GCBC. Targeting interventions towards population sub-groups (e.g., young people) is not a new strategy. However, the population health ethical implications of targeting population subgroups are only beginning to be examined. Little is known about how this approach to intervention may operate differentially within and across targeted groups and there is concern that these approaches may exacerbate health inequity (particularly among the most vulnerable population subgroups). Furthermore, targeted approaches tend to be heavily focused on agentic practices (that is, on changing the individual behaviour), rather than structural interventions (on changing the conditions in which the behaviour occurs). This proposal brings together an interdisciplinary team of researchers and trainees who are new to the field of ethics. The proposed pilot study nested within the current application will examine how the GCBC experience attempts to ameliorate individual risk, as well as the ways in which it deploys an institutionalized discourse that attempts to deconstruct social structures that (re)produce social injustices (e.g., heteronormativity; misogyny) that have important implications for young people's sexual health. The pilot study also will form the basis of two PhD dissertations. Overall, this provides a first step towards strengthening new proposals related to population health ethics to be submitted in other CIHR funding opportunities