Implications of COVID-19 Restrictions on the Ethics and Methods of a Multi-Site Study on Alcohol and Other Drug (AOD) Use Treatment among Men in South Africa

Public health measures for medical emergencies generate methodological and ethical challenges for human research. Using Emanuel et al.'s framework, we assessed the ethical integrity of the research methods used in a men's alcohol and other drug (AOD) use disorder study following their revision due to COVID-19 restrictions in South Africa. Following the amendments, the study's social value, favorable risk-benefit ratio, and respect for participants increased. Collaborative partnership, scientific validity, fair participant selection, independent review, and informed consent improved in terms of successful stakeholder engagements and interviewing procedures, but were compromised due to a cellphone access eligibility criterion and complicated consenting procedures. Methodological and ethical challenges of research during health emergencies can be navigated with flexibility and innovation.