title: Successes and challenges of HIV prevention in men who have sex with men.
abstract: Men who have sex with men (MSM) have been substantially affected by HIV epidemics worldwide. Epidemics in MSM are re-emerging in many high-income countries and gaining greater recognition in many low-income and middle-income countries. Better HIV prevention strategies are urgently needed. Our review of HIV prevention strategies for MSM identified several important themes. At the beginning of the epidemic, stand-alone behavioural interventions mostly aimed to reduce unprotected anal intercourse, which, although somewhat efficacious, did not reduce HIV transmission. Biomedical prevention strategies reduce the incidence of HIV infection. Delivery of barrier and biomedical interventions with coordinated behavioural and structural strategies could optimise the effectiveness of prevention. Modelling suggests that, with sufficient coverage, available interventions are sufficient to avert at least a quarter of new HIV infections in MSM in diverse countries. Scale-up of HIV prevention programmes for MSM is difficult because of homophobia and bias, suboptimum access to HIV testing and care, and financial constraints.
authors: Rollins School of Public Health, Emory University, Atlanta 30322, GA, USA. patrick.sullivan@emory.edu
authors: Patrick S
authors: PS
authors: Sullivan
authors: Alex
authors: A
authors: Carballo-Diéguez
authors: Thomas
authors: T
authors: Coates
authors: Steven M
authors: SM
authors: Goodreau
authors: Ian
authors: I
authors: McGowan
authors: Eduard J
authors: EJ
authors: Sanders
authors: Adrian
authors: A
authors: Smith
authors: Prabuddhagopal
authors: P
authors: Goswami
authors: Jorge
authors: J
authors: Sanchez
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D017280:Condoms; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D011315:Preventive Medicine / Q000379:methods*; D012725:Sexual Behavior
chemical_list: D044966:Anti-Retroviral Agents