ABSTRACT
Between 2004 and 2005, the first multisite clinical trial tested whether an existing, marketed antiretroviral drug, tenofovir (tenofovir disoproxil fumarate, or TDF), could prevent HIV transmission. Known as pre-exposure prophylaxis (PrEP), several institutions formed partnerships to carry out the research. In Cambodia, a national sex workers' union, the Women's Network for Unity (WNU), made its complaints about the trial protocol clear in national and international press conferences. It was thought that once communities could better understand the principles of HIV clinical research, there would be no unnecessary failure to implement PrEP trials. But in Malawi and Nigeria, the communities that raised similar and more extended questions about these initial PrEP trials were university ethicists and research scientists. It is argued that debates over PrEP science rationales in the Malawi case are embedded in postcolonial politics that have shaped the structural possibilities of scientific research in the African postcolony.
