Thai-US CDC Tenofovir Prevention Trial Ignores International Ethical
Standards and Exploits Injecting Drug Users in Thailand

The Thai Drug Users' Network (TDN) and other Thai AIDS advocacy
organizations oppose the recent approval of a pre-exposure
prophylaxis trial, pointing to ethical violations and an "utter
lack" of community involvement in the protocol design
(Bangkok, March 10, 2005) - The Thai Drug Users' Network (TDN) and
other AIDS advocacy organizations including the Center for AIDS
Rights (CAR) and the Thai NGO Coalition on AIDS (TNCA) held a press
conference today to express their concerns with a trial planned
among 1,600 IDU in Bangkok, which received approval from Thailand's
ethical review body on March 8, 2005.

"Yet again, we drug users are treated as less than human, not worth
the same basic dignity and rights as others. Even though the
researchers know Thai IDU are at high risk for HIV, they refuse to
provide clean injecting equipment in the context of this trial
despite using a placebo," said Paisan Suwannawong, Director of the
Thai AIDS Treatment Action Group (TTAG). TDN and allies are
concerned that the same standards are not being followed in Thailand
as in other countries where a similar trial is being held. "In the
African sites, condoms are offered as a matter of course to the
trial participants, who are chosen for their high-risk sexual
behavior."

The multi-site trial, though with different sponsors, has already
been cancelled in Cambodia and Cameroon after target group
communities expressed similar concerns over community involvement
and unethical trial practices.

TDN is also concerned over the standard of care provided in the
trial. In a violent drug war started in 2003, people involved with
drugs were subjected to numerous human rights violations which
pushed them underground and away from essential services, and
resulted in nearly 3,000 extra-judicial executions that remain
largely uninvestigated. "Thailand has no harm reduction policy, and
drug users are routinely denied care, including anti-retroviral
therapy, or made to quit drugs first," said Seree Jintakanon,
chairman of TDN. "Virtually none of the nearly 50,000 people on ARV
in Thailand are injecting drug users, yet now we are made to believe
that IDU will receive the highest standard of care in this trial.
For people who seroconvert during the trial, or are screened out
because of their HIV at the start of the trial, we have no evidence
that they will receive appropriate care."

Trial participants will be recruited at their point of service,
methadone clinics. The protesters are concerned that this will
result in coercion to participate in the trial. Nantapol
Cheunchooklin, who was a trial participant in an earlier vaccine
trial among IDU in Bangkok, remembers, "I was afraid that if I
refused being recruited in the trial, I might displease the clinic
staff or that it would have a negative consequence on the methadone
I was receiving."

Earlier this month, TDN and several other AIDS advocacy
organizations, using the self-appointed umbrella name, the "Thai
Tenofovir Community Working Group," asked UNAIDS to intervene to try
and postpone the commencement of the trial in order to have real
community dialogue, mechanisms for involvement, and resolutions of
perceived trial design problems. "We 100% support research into new
and better options for HIV prevention. But, Tenofovir, which would
have to be taken every day for the rest of one's life, costs nearly
US$500/month. Trial participants would only get it free for one
year. We are not hopeful that this method of prevention would be
available for IDU or for ANY Thai person for that matter, ever. If
IDU and PLWHA were invited to be part of the process from the
beginning, however, we might have negotiated better post-trial
access," said Mr. Jintakanon.

For further information, contact:
Seree Jintakanon, TDN (Thai lang.) +66-1-384-4469
Paisan Suwannawong, TTAG (Thai/Eng.) +66-1-824-5434