HIV Prevention for Gay and Bisexual Men in Metropolitan Cities

Abstract

The acquired immunodeficiency syndrome (AIDS) epidemic continues to exert a profound toll on urban gay men. As of the end of 1992, more than 150,000 cases of AIDS had been reported in the United States among men who have had sex with other men (Centers for Disease Control, 1993). It is estimated that by the end of 1993, between 240,000 and 280,000 homosexual and bisexual men will have developed AIDS, with between 30,000 and 50,000 men developing AIDS during 1993 alone (Centers for Disease Control, 1990). The majority of U.S. gay and bisexual men with human immunodeficiency virus (HIV) or AIDS reside in major metropolitan areas (Centers for Disease Control, 1993). The National Academy of Sciences Commission on AIDS has predicted that AIDS will “settle in” to gay and minority communities; thus the need for effective preventive interventions for those communities is tremendous. In this chapter, we review the prevalence and predictors of HIV infection and HIV risk behavior among urban gay men, discuss preventive interventions that have been used to reduce HIV risk-taking among urban gay men, highlight strengths and limitations of the existing literature, and present suggestions for future research.