A local Ministry of Health has requested a prevalence/behavioral surveillance study for sexually transmitted infection (STI) among commercial sex workers. Participants in this study will be tested for 3 common STIs and participate in an interview. Participants will receive a card with a number linking them to their blood sample. Women who donate blood will have the option of presenting their card to get the results of the STI tests. Those with positive results for any of the 3 infections will be offered free treatment. In addition, all participants will receive a small gift in return for their participation.

The target population consists of brothel-based sex workers who are strictly controlled by the brothel managers. Prior to initiating the research, the researcher meets with the brothel manager to ask permission to conduct the study. During the meeting, the manager states that all of the women working in the brothel will participate in the study. 

Questions: (Click on the question to reveal possible answers.)

1. What steps can the research staff take to ensure that the informed consent is freely given by all participants?
   
   
2. If a woman chooses not to participate in the study, what can be done to protect her from retaliation by the manager?
   
   
3. If you believe that the women will not be able to give voluntary informed consent, what alternatives could you suggest to the Ministry of Health?