U.S. Public Health Service STD Experiments in Guatemala (1946–1948) and Their Aftermath

Abstract

The U.S. Public Health Service’s sexually transmitted disease (STD) experiments in Guatemala are an important case study not only in human subjects research transgressions but also in the response to serious lapses in research ethics. This case study describes how individuals in the STD experiments were tested, exposed to STDs, and exploited as the source of biological specimens—all without informed consent and often with active deceit. It also explores and evaluates governmental and professional responses that followed the public revelation of these experiments, including by academic institutions, professional organizations, and the U.S. federal government, pushing us to reconsider both how we prevent such lapses in the future and how we respond when they are first revealed.

Barriers to the Wider Use of Pre-exposure Prophylaxis in the United States: A Narrative Review

“…As noted previously, feelings of distrust may be attributed to social stigma at the provider level; in a number of studies, participants were alienated from their healthcare system as a result of experienced and anticipated discriminatory judgment from providers in the form of racism or homophobia (Table 6 ). Furthermore, there have been a number of malign events in the US medical establishment that have led to distrust in the healthcare system, particularly for Black communities (e.g., the Tuskegee syphilis study, the case of Henrietta Lacks, and the 1946–1948 Guatemalan sexually transmitted disease experiments) [ 62 – 65 ]. Medical distrust can also manifest as conspiracy beliefs; such beliefs have acted as a barrier to HIV prevention in the USA for years, with high prevalence within some Black communities attributed to historical racial discrimination [ 66 – 68 ].…”

Ethical framework for head and neck cancer care impacted by COVID‐19

“…Some populations have been victims of cultural, racial, geographic, and economic discrimination for generations and societal stress points such as pandemics can worsen both explicit and implicit biases 16 . Health care providers must deliberately partner with underrepresented groups to assure that the risks of care disparities are minimized in the face of crisis.…”

Laboratory Perspective on Racial Disparities in Sexually Transmitted Infections

“…Social scientists note that the key motif underlying these factors is the history and persistence of segregation as the primary manifestation of structural racism and racial inequality in the US ( 6 ), a phenomenon with far-reaching implications within medicine and research. Perhaps the most appalling examples from the last century are the unethical syphilis natural history studies conducted by the US Public Health Service on Guatemalans during World War II ( 7 ) and on Black men in the South from 1932–1972 ( 8 ). These historical blemishes, in addition to experienced discrimination and differential delivery of care due to race/ethnicity or socioeconomic status, provider bias, and cultural insensitivity, are thought to contribute collectively to mistrust in the medical system that limits public health efforts to reduce STI ( 9–11 ).…”