World AIDS Day, dedicated to raising awareness of HIV, is an opportunity unlike any other to take stock of what’s been achieved in the HIV response and what challenges lie ahead.
John de Wit and Philippe Adam from the UNSW Centre for Social Research in Health examine opportunities to strengthen HIV prevention for gay men in Australia in their contribution to Biomedical advances in HIV prevention: Social and behavioral perspectives. This exciting new book is edited by Lisa Eaton and Seth Kalichman from the University of Connecticut and has recently been published by Springer.
In their chapter, entitled ‘Revolution or evolution? What can approaches based on the use of antiretroviral drugs contribute to HIV prevention in gay communities in high-income countries?, de Wit and Adam review the evidence for the possible benefits of the use of HIV treatments for prevention in Australia. Their in-depth and comprehensive analysis of potential population effects of early initiation of antiretroviral treatment and pre-exposure prophylaxis cautions against overly optimistic expectations.
In the current context of a strong increase in unprotected anal intercourse among MSM, emerging treatment-based approaches instil hope for a future without HIV and contribute to re-invigorating HIV prevention. Effectively curbing trends in HIV rates also requires producing new knowledge on factors that shape condom use and HIV/STI testing. It also requires facilitating productive partnership between behavioural prevention researchers and health educators to produce innovative campaigns for gay men. Collaborative work on a new generation of theory-driven, research-informed strategies is needed to comprehensively and efficiently address the myriad individual, social and structural barriers to consistent condoms use and regular testing among some gay men.