How do we stop the hyperepidemic in gay men?
A number of presentations at the 19th International AIDS Conference explored the ‘hyperepidemic’ of HIV amongst men who have sex with men, and especially black MSM.
A paper presented by Gregorio Millet (pictured above at a White House reception honoring people working in AIDS) showed that, at least in the USA, the extremely high incidence and prevalence of HIV in this group is not driven by higher levels of unsafe sex. Instead, very high prevalence, the ease with which HIV is transmitted during anal sex, and the fact that black men (and some other subpopulations of gay men) have sex within small and multiply-connected networks have created a situation in which HIV is hard to avoid.
Given this, what prevention methods would work in gay men? The one that has been talked about most keenly and which continued to generate a great deal of data and debate at Washington was pre-exposure prophylaxis (PrEP) – taking antiretrovirals (ARVs) to prevent, rather than treat, HIV.
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