Population health ethics: Investigating the implications of 'targeting' socially-defined population subgroups to promote health

Targeting interventions towards population sub-groups (as defined according to their shared social characteristics) is not a new strategy; this approach has inspired the bulk of population health interventions in Canada and abroad. However, the ethical implications of targeting population subgroups is only beginning to be examined. Using STI/HIV testing interventions targeted at young men (across low-, middle-, and high-income settings) as examples, the proposed study offers an opportunity to address knowledge gaps within the field of population health ethics. The proposed study examines the ethical implications of targeting socially defined population subgroups to promote population health. The proposed study raises questions about ethical ways to intervene to address a serious population (and personal) health problem - STI/HIV rates among young men. The proposed longitudinal 5-year study will capture and track the ethical implications of STI/HIV testing interventions that target young men and the study objectives include: 1.To identify and track the dominant narratives appearing in policy and programming documents pertaining to STI/HIV testing of young men in three types of places (e.g., low-, middle-, and high-income settings) and to examine whether particular values and ethical principles are privileged in the discourse presented across these documents and over time; 2.To analyze interview accounts from men, service providers and policy makers regarding their experiences with STI/HIV testing interventions in order to assess the ways in which equity issues (e.g., population-level benefits as compared to individually-oriented benefits; more immediate impacts juxtaposed to longer term effects) are perceived and experienced in a variety of settings; 3.To assess the ways in which dominant institutional discourses regarding STI/HIV testing for young men are taken up (or rejected) and how that might vary across settings over time.