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This work explores some of the complex ethical quandaries entailed by proposed phase III HIV preventive vaccine trials. It argues that such trials must be initiated as soon as is politically and ethically feasible on the one hand, and, on the other, that no such trials should be undertaken until we can assure full compliance with the Nuremberg Code and the WHO/CIOMS International Ethical Guidelines for Biomedical Research Involving Human Subjects. The tension between these two positions is documented, and suggestions offered for how to think about possible resolutions.