Preventing HIV infection in gay men: Help and hindrance

Abstract

To date individually-based approaches to the prevention of HIV infection in gay men have not been demonstrated to work in terms of sexual behaviour change. There is currently great optimism that community-based approaches can be shown to deliver the outcome we seek of a reduced incidence of HIV infection in gay men. This paper reviews the evidence for such a position, but also identifies obstacles to the successful evaluation of such interventions. Can they work when most unsafe sex occurs within the context of regular relationships? Are community-based interventions suited to this situation? What hinders the successful implementation of such programmes? The paper identifies those factors which can be seen to help our efforts to determine the effectiveness of interventions, as well as those elements that hinder the development of a strategy which could take us further forward in developing culturally appropriate prevention programmes for the group that continues to be most affected by the AIDS epidemic.