What is the role of a CAB in biomedical HIV prevention research in South Africa? CABS are the most common mechanism for engaging communities in research. They provide an ‘’independent advisory voice’’ (UNAIDS, 2011, p. 30) and consist of stakeholders drawn from the community. We conducted qualitative research in a peri-urban community in Western Cape Province, South Africa. Data was collected using semi-structured interviews with a sample of 20 research centre staff and CAB members.

Findings Highlight diverging expectations and very real power imbalances between CAB and research centre staff. Relational challenges Mistrust between CAB and research centre staff Role expectations and levels of participation of CAB in CE Active participation and access to power Deriving mutual benefit These factors act as barriers to meaningful CE in the study setting and raise the question: How do we accommodate different sets of expectations in a way that generates mutual benefit?

Conclusions Clinical research in communities are social processes. Strengthening the relational component of clinical trials - working through mistrust, conflict and frustrations between the CAB and research centre staff. CAB members can take more active roles in the research, moving beyond input into the operational (recruitment and retention) and the ethical aspects of the research. Mutually beneficial partnerships, ongoing and transparent dialogue – achieve both the goals of the scientific enterprise, as well as the local community.