“Always be prepared,” the Boy Scout motto, may someday serve as the sexworker’s mantra if PREP, or pre-exposure prophylaxis, proveseffective.  A daily HIV med taken by high-risk neggies, it holdshope as a cheap and easy virus blocker. But right now, politics istrumping science: Long-awaited tests have been hampered by protestsover research methods, shutting down trials of the leading PREPcontender, Gilead’s nuke, Viread. If it works, Viread could be used bymillions unable to negotiate condoms. With so much at stake, feudingactivists, funders, scientists and officials met in Seattle in May totry to hammer out their differences. “It didn’t make sense to beshouting at each other,” says Gregg Gonsalves, director of treatmentand prevention advocacy at Gay Men’s Health Crisis, which helped planthe meeting.

Researchers have long theorizedthat if an HIV med given within days of exposure could preventinfection, taking it before exposure might work, too. But there’s aconflict of interest in running prevention tests: Ethics dictatethat  subjects get the best counseling and care available, but inorder to determine that the drug stops HIV, some subjects must riskexposure. “You only know if prevention technologies work if you haveinfections,” says Mitchell Warren, head of the AIDS Vaccine AdvocacyCoalition. Stuck on these scientific and moral hooks, PREP trials tookuntil 2004 to launch.

And the trouble onlymounted. No sooner were sex workers in Cambodia enrolled than theybegan organizing against what they said was a lack of informed consent,hinting that participants were mere guinea pigs of researchersinterested in better trial data. Activists jumped on the bandwagon,too, blasting funders for failing to offer lifelong meds to subjectswho got infected.

In a Cameroon trial, ACT UPParis raised its own red flags. “The screening and consent forms werein English,” says ACT UP Paris’ Fabrice Pilorgé (some Camerooniansspeak French). “Another problem was that they wouldn’t provide thefemale condom.” In the  Thai trial, drug-using participants weredenied free needles. Well-organized protests at Bangkok’s 2004 globalAIDS confab grabbed headlines, causing Cambodia to pull out andCameroon to suspend tests. “I was furious,” says Gonsalves. “Is that avictory—to shut down research?”
But in Seattle,some common ground was reportedly reached. “It’s safe to say nobodyleft that meeting against the research itself,” says Warren. Gonsalvesagrees. “Research is important,” he says. “But it’s also important thatit’s done ethically.” Meanwhile, trials proceed in San Francisco,Atlanta and six foreign countries, while UNAIDS plans its own talks onthe ethics of prevention studies. As for Cambodian prostitutes, theytake their risks as they come,PREP-lessly.