1. What implications did the lack of inclusion of clean needles in the prevention package have on trial results?
Not being able to include clean needles in the prevention package for such a trial could compromise outcome of trials. However, the dilemma is caused by the legal versus a moral and ethical code. One might consider the role of education in this scenario and the extent to which the trial candidates would be educated to be able to select clean needles during the trial. These candidates are drug users – just maybe the fact that they are HIV negative could be as a result of safe practices. We are assuming that the users may be susceptible to using unclean needles. What if these needles are reused by the said user? HIV has other modes of transmission as well. It would be unfair to state that the results are outright compromised.

2. How can researchers engage stakeholders to better negotiate comprehensive prevention packages tailored to the needs of diverse subgroups?

The legal fraternity and policy makers in this particular scenario needed to be engaged in the decision making process of such trials. Throughout the GPP guidelines emphasis is made on the use of the infamous CABs and other stakeholder engagements from inception to implementation and results management. The use of social media and creative modes of communication also formed a forum for engaging stakeholders from every strata.