“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 theorized that if an HIVmed given within days of exposure could prevent infection, taking itbefore exposure might work, too. But there’s a conflict of interest inrunning prevention tests: Ethics dictate that subjects get the bestcounseling and care available, but in order to determine that the drugstops HIV, some subjects must risk exposure. “You only know ifprevention technologies work if you have infections,” says MitchellWarren, head of the AIDS Vaccine Advocacy Coalition. Stuck on thesescientific and moral hooks, PREP trials took until 2004 to launch.

Andthe trouble only mounted. No sooner were sex workers in Cambodiaenrolled than they began organizing against what they said was a lackof informed consent, hinting that participants were mere guinea pigs ofresearchers interested in better trial data. Activists jumped on thebandwagon, too, blasting funders for failing to offer lifelong meds tosubjects who got infected.

In a Cameroon trial, ACT UP Parisraised its own red flags. “The screening and consent forms were inEnglish,” says ACT UP Paris’ Fabrice Pilorgé (some Cameroonians speakFrench). “Another problem was that they wouldn’t provide the femalecondom.” In the Thai trial, drug-using participants were denied freeneedles. Well-organized protests at Bangkok’s 2004 global AIDS confabgrabbed headlines, causing Cambodia to pull out and Cameroon to suspendtests. “I was furious,” says Gonsalves. “Is that a victory—to shut downresearch?”

But in Seattle, some common ground was reportedlyreached. “It’s safe to say nobody left that meeting against theresearch itself,” says Warren. Gonsalves agrees. “Research isimportant,” he says. “But it’s also important that it’s doneethically.” Meanwhile, trials proceed in San Francisco, Atlanta and sixforeign countries, while UNAIDS plans its own talks on the ethics ofprevention studies. As for Cambodian prostitutes, they take their risksas they come, PREP-lessly.