Doing Good Well in Unethical Times: A Call to Action for HIV Prevention Research

Since the emergence of the AIDS epidemic, HIV research has been a mirror for humanity's moral choices that transformed biomedical and social science ethics. Four decades after the epidemic the field again faces an ethical reckoning. Once defined by its moral courage and community partnership, HIV research now operates amid political interference, data insecurity, funding contractions, and threats to academic freedom. Drawing on insights from the HIV and Drug Abuse Prevention Research Ethics Training Institute's 2025 Research Symposium, "Ethics, Equity, and the Next 15 Years of HIV Research," this commentary calls for a new era of HIV science grounded in solidarity, humility, and justice rather than procedural compliance. We argue that the moral frameworks forged through the history of HIV research-health justice, respect for personhood, and trustworthiness-are essential tools for survival and resistance in today's restrictive research climate. The paper highlights four ethical imperatives: (1) confronting the political nature of science and the erosion of trust in research institutions with the ethics of resistance; (2) ending a health disparities research cycle that risks perpetuating inequities rather than eliminating them; (3) developing an ethics of implementation science that sustains community benefits beyond the life of a grant; and (4) mentoring the next generation of HIV scientists in the moral frameworks necessary for conducting research with humility, reflexivity and courage. The essay concludes with concrete pathways for action in political and ethically challenging times outlining the commitments necessary to enact principled resistance with integrity.