African Journal of AIDS Research 2014, 13(4): 393–398 Printed in South Africa — All rights reserved African Journal of AIDS Research is co-published by NISC (Pty) Ltd and Routledge, Taylor & Francis Group Copyright © NISC (Pty) Ltd AJAR ISSN 1608-5906 EISSN 1727-9445 http://dx.doi.org/10.2989/16085906.2014.985239 Introduction Two-thirds of new HIV infections occur in sub-Saharan Africa (UNAIDS 2012). Partner reduction and condom use alone have been insufficient to halt the epidemic. New HIV prevention tools that are currently in development include oral pre-exposure prophylaxis (PrEP) with antiret- roviral drugs (ARVs), vaginal gels and rings (‘microbi- cides’) containing ARVs, and prophylactic HIV vaccines. Mozambique has not yet contributed as much to this international research effort as neighbouring countries, such as South Africa and Zimbabwe, but is likely to become more involved in the near future. Clinical trial sites for HIV prevention interventions are being prepared in Maputo, Beira, and Manhiça (González et al. 2012, Dubé et al. 2014). Mozambique has a generalised HIV epidemic with the highest prevalence in Sofala province in central Mozambique: 17.8% among 15–49-year-old women and 12.6% among men of the same age in 2009 (INS et al. 2010). Beira, a port city with a population of about 430 000 persons, is the capital city of Sofala province. The success of HIV prevention trials depends on the willingness to participate (WTP) of target populations. In preparation for future trials, we assessed WTP among women and men in Beira, Mozambique. Methods Ethical approvals were obtained from the Mozambican National Commission for Bioethics (Maputo, Mozambique) and the Protection of Human Subjects Committee of FHI 360 (Durham, USA). Willingness to participate in future HIV prevention trials in Beira, Mozambique Ivete Meque 1* , Karine Dubé 2,3 , Lotte Bierhuizen 4,5 , Arlinda Zango 1 , Nienke Veldhuijzen 4,5 , Fidelina Cumbe 1 , Paul J Feldblum 2 and Janneke van de Wijgert 4,6 1 Universidade Católica de Moçambique/Catholic University of Mozambique (UCM), Centro de Investigação de Doenças Infecciosas/Research Center for Infectious Diseases (CIDI), Beira, Mozambique 2 FHI 360, Durham, North Carolina, USA 3 Current affiliation: Institute of Global Health and Infectious Diseases (IGHID), University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA 4 Amsterdam Institute of Global Health and Development (AIGHD), Amsterdam, The Netherlands 5 Vrije Universiteit, Amsterdam, The Netherlands 6 Current affiliation: University of Liverpool, Institute of Infection and Global Health, Liverpool, UK *Corresponding author, email: ive.meque@yahoo.com.br In preparation for trials of new HIV prevention methods, willingness to participate (WTP) was assessed in Beira, Mozambique. A totla of 1 019 women participating in an HIV incidence study, and 97 men participating in a separate WTP survey, were interviewed. When comparing the answers to questions that were identical in the two studies, WTP was higher among women than men for all prevention methods. Among women, WTP was highest for trials evaluating daily oral pre-exposure prophylaxis (PrEP; 84.4% reporting very likely to participate), followed by vaccination (77.8%), daily vaginal gel use (67.7%), coital vaginal gel use (67.1%) and monthly vaginal ring use (47.7%). Among men, WTP was highest for trials evaluating vaccination (57.6%), followed by daily vaginal gel use for female sexual partners (52.5%), daily oral PrEP (49.5%), coital vaginal gel use for female sexual partners (46.4%) and monthly vaginal ring use for female sexual partners (39.4%). Among men, the most important motivators for trial participation were social benefits, whereas personal risks (most notably receiving injections and/or blood draws) were deterrents; this was not assessed in women. Other important lessons learnt are that male circumcision and antiretroviral drugs were not generally recognised as ways to prevent HIV, that having to use hormonal contraception during trial participation will likely reduce WTP, and that evening clinics are not likely to be popular. The barriers reported in this and other studies may be challenging but are not impossible to overcome. Keywords: HIV prevention, Mozambique, pre-exposure prophylaxis, vaccine, vaginal microbicide, willingness to participate