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Though it may offer more effective protection for certain at\u2010risk groups than conventional prevention strategies (such as sexual partner reduction, condom use, and prevention of mother\u2010to\u2010child transmission), <jats:styled-content style=\"fixed-case\">PrEP<\/jats:styled-content> is more costly. <jats:styled-content style=\"fixed-case\">PrEP<\/jats:styled-content> requires more ongoing contact between individuals and providers, and a level of surveillance from the health system that is not necessary with other preventive measures. In this sense, it represents a new bio\u2010technology for <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevention that poses particular challenges for worldwide implementation, given developing countries\u2019 struggling health systems and incomplete <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> treatment programs. Since the emergence of <jats:styled-content style=\"fixed-case\">PrEP<\/jats:styled-content> has stimulated ethical discussions premised on incomplete knowledge of efficacy and implementation, this paper explores the ethical parameters of a likely scenario for <jats:styled-content style=\"fixed-case\">PrEP<\/jats:styled-content> usage in a single, resource\u2010poor country. We first develop a plausible model for <jats:styled-content style=\"fixed-case\">PrEP<\/jats:styled-content> deployment and utilization based on current <jats:styled-content style=\"fixed-case\">PrEP<\/jats:styled-content> research, while carefully considering the reigning institutional values of feasibility and effectiveness in global health approaches. Drawing on ethnographic research of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> treatment and prevention approaches in <jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>esotho, we address ethical questions arising from this scenario of <jats:styled-content style=\"fixed-case\">PrEP<\/jats:styled-content> delivery. <jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>esotho presents a compelling and emblematic case study of PrEP's potential successes and pitfalls in a developing country, given the country's high <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> prevalence, struggles to achieve universal access to <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> treatment regimes, continued existence of stigma around the epidemic, and difficulties in addressing persistent social inequalities that fuel infections.<\/jats:p>","DOI":"10.1111\/dewb.12029","type":"journal-article","created":{"date-parts":[[2013,6,26]],"date-time":"2013-06-26T03:37:00Z","timestamp":1372217820000},"page":"70-78","source":"Crossref","is-referenced-by-count":7,"title":["From modeling to morals: Imagining the future of <scp>HIV PREP<\/scp> in <scp>L<\/scp>esotho"],"prefix":"10.1111","volume":"13","author":[{"given":"Nora J.","family":"Kenworthy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Bulled","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,6,25]]},"reference":[{"issue":"3","key":"e_1_2_8_2_1","first-page":"65","article-title":"Interim Guidance: Preexposure Prophylaxis for the Prevention of HIV Infection in Men Who Have Sex with Men","volume":"60","author":"Smith D.","year":"2011","journal-title":"MMWR"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1011205"},{"key":"e_1_2_8_4_1","unstructured":"Smith et\u2009al. op. cit.note 1 p.7."},{"key":"e_1_2_8_5_1","unstructured":"G.Cairns.The Perils of Success: What if the New Prevention Methods Work?HIV & AIDS Information2012;190."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61136-7"},{"key":"e_1_2_8_7_1","unstructured":"Conference proceedings 6th IAS Conference; July 17\u201320. 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