HIV Prevention For Gay Men Research Articles

Reframing HIV prevention for gay men in the United States.

The HIV epidemic in the United States has affected at least two generations of gay men. Despite numerous efforts to intervene on this public health crisis, HIV infections continue to escalate, especially among young men. This condition is compounded by an ever-growing number of gay men who are aging and living with HIV. We must enact an innovative and proactive vision and framework for HIV prevention that moves us beyond the undertakings rooted in social-cognitive paradigms that have informed this work for the past 25 years. A new framework for HIV prevention must give voice to gay men; must consider the totality of their lives; must delineate the underlying logic, which directs their relation to sex and HIV; and must concurrently respect their diverse life experiences. This approach should be rooted in a biopsychosocial paradigm, should be informed by both theory and practice, and should be directed by three theoretical lenses--a theory of syndemics, developmental theories, and contextual understandings of HIV disease. Taken together, these elements are a call to action for research and practice psychologists who are working to improve the lives of gay men.

Structural and environmental HIV prevention for gay and bisexual men

HIV prevention efforts for gay and bisexual men in the United States began as community-mobilizing efforts, but have drifted towards focusing more on the individual. Given lowering prevalence and incidence, it is unreasonable to expect continued community support for high levels of prevention activity. Structural and environmental interventions present one useful, complementary set of alternatives to support prevention efforts. This paper reviews the gay community's relationship with these interventions, including its intensely debated approaches to reducing HIV transmission within bathhouses. The implications for HIV prevention for gay men of larger societal factors, including economic development and economic motivation, migration, and legislation, are then considered. Individual rights, community and public-health interests must be given particularly cautious consideration when designing and implementing structural and environmental interventions.

Not All Men, Situations, and Actions Are Equal

SUMMARY Since 1985, annual surveys conducted in the French gay press show that gay men in France have made considerable changes in their sexual behavior due to the AIDS epidemic. However, risky behavior still occurs. In this article, some ideas which have been assumed concerning residual risk among gay men are tested. The research questions were: (1) Should all unprotected acts of anal intercourse be considered risky? (2) Has a phenomenon of relapse really occurred among gay men in France? and, (3) Are risks only limited to men who are on the margin of the gay community? Before answering these questions, major landmarks in HIV prevention for gay men in France are reviewed. Then, on the basis of the results of the 1995 Gay Press Surrey, subjects' perception of the degree to which they are socially accepted, and the diversity of homosexual lifestyles are presented, finally, we describe how respondents have adjusted to HIV-risk at a time when there has been much talk about the re-emergence of risk behaviors and a resurgence of the AIDS epidemic among homosexual men.

Context is Everything

SUMMARY As we approach the third decade of AIDS, HIV prevention in the United States confronts expanding public concern about continuing infections among gay men. This paper provides a brief history of HIV prevention efforts among gay men in the United States, as well as a succinct analysis of its successes and failures. By focusing on lessons learned from work in the 1980s-as well as lessons which have not yet' been learned-the author suggests future directions in HIVprevention for gay men which emphasize critical analysis of epidemiological trends, and countering the merging of gay identity with HIV infection. Supporting men to gain greater authority and responsibility1 for their sexual community-building and redevelopment is necessary for lowering the infection rate among successive generations of gay men.