In This Together

Abstract

SUMMARY Both epidemiologically and psychologically, the reigning self-interest paradigm of HIV prevention is growing increasingly obsolete, which will likely only increase with wider use of combination therapies. While self-interest notions form the core of most American HTV prevention theory and practice, data indicate that self-interest models increasingly fail both negative and positive gay men. There is an urgent need for broader, more emotionally-resonant prevention concepts. Diverse consistent, and significant data on behaviors including condom use, partner choice, volunteerism, and caretaking imply that values jof altruism and other-centered motivators may play central, strong roles in gay men'S HIV safety decisions. Values of “prevention! altruism” remain little understood, researched, or appreciated. Data show that sexual risk is inherently dyadic, gay men'S risk is increasingly relational, and a clear majority of gay men consistently manage sexual risk. Yet we understand little of the values of men who are largely safe, instead of those most risky, and less about how their values of nurturance and caretaking, ethics, hopes for collective survival, or relations with friends and community help support them in staying safe. A wide range of implications of prevention altruism are suggested and diverse research directions proposed to define a new domin of “Prevention caretaking.”