title: Stigma, gay men and biomedical prevention: the challenges and opportunities of a rapidly changing HIV prevention landscape.
abstract: Improvements in biomedical technologies, combined with changing social attitudes to sexual minorities, provide new opportunities for HIV prevention among gay and other men who have sex with men (GMSM). The potential of these new biomedical technologies (biotechnologies) to reduce HIV transmission and the impact of HIV among GMSM will depend, in part, on the degree to which they challenge prejudicial attitudes, practices and stigma directed against gay men and people living with HIV (PLHIV). At the structural level, stigma regarding gay men and HIV can influence the scale-up of new biotechnologies and negatively affect GMSM's access to and use of these technologies. At the personal level, stigma can affect individual gay men's sense of value and confidence as they negotiate serodiscordant relationships or access services. This paper argues that maximising the benefits of new biomedical technologies depends on reducing stigma directed at sexual minorities and people living with HIV and promoting positive social changes towards and within GMSM communities. HIV research, policy and programs will need to invest in: (1) responding to structural and institutional stigma; (2) health promotion and health services that recognise and work to address the impact of stigma on GMSM's incorporation of new HIV prevention biotechnologies; (3) enhanced mobilisation and participation of GMSM and PLHIV in new approaches to HIV prevention; and (4) expanded approaches to research and evaluation in stigma reduction and its relationship with HIV prevention. The HIV response must become bolder in resourcing, designing and evaluating programs that interact with and influence stigma at multiple levels, including structural-level stigma.
authors.affiliation: La Trobe University, Australian Research Centre in Sex, Health and Society, 215 Franklin Street, Melbourne, Vic. 3000, Australia.
authors.forename: Graham
authors.initials: G
authors.lastname: Brown
authors.affiliation: La Trobe University - Gay and Lesbian Health Victoria, 215 Franklin Street, Melbourne, Vic. 3000, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Leonard
authors.affiliation: La Trobe University, Australian Research Centre in Sex, Health and Society, 215 Franklin Street, Melbourne, Vic. 3000, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Lyons
authors.affiliation: La Trobe University, Australian Research Centre in Sex, Health and Society, 215 Franklin Street, Melbourne, Vic. 3000, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Power
authors.affiliation: Deutsche AIDS-Hilfe e.V, Wilhelmstraße 138, 10963 Berlin, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Sander
authors.affiliation: AIDS United, 1424K Street, N.W., Suite 200, Washington, DC 20005, USA.
authors.forename: William
authors.initials: W
authors.lastname: McColl
authors.affiliation: AIDS United, 1424K Street, N.W., Suite 200, Washington, DC 20005, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Johnson
authors.affiliation: Terrence Higgins Trust, 314-320 Gray's Inn Road, London, WC1X 8DP, UK.
authors.forename: Cary
authors.initials: C
authors.lastname: James
authors.affiliation: GMFA, Unit 22, Eurolink Business Centre, 49 Effra Road, London SW2 1BZ, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hodson
authors.affiliation: La Trobe University, Australian Research Centre in Sex, Health and Society, 215 Franklin Street, Melbourne, Vic. 3000, Australia.
authors.forename: Marina
authors.initials: M
authors.lastname: Carman
mesh_terms: D001727:Bisexuality; D015658:HIV Infections / Q000517:prevention & control*; D006291:Health Policy; D006293:Health Promotion / Q000379:methods; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D012725:Sexual Behavior; D057545:Social Stigma