Comprehensive prevention with HIV positive gay men

Abstract

HIV positive gay men have always been powerful advocates for HIV prevention and care. Renewed efforts to strengthen prevention with this group may benefit from the touchstone concepts of combination prevention and sexual health promotion. These concepts suggest that comprehensive HIV prevention should holistically promote the physical and mental health of HIV positive gay men, and must additionally extend to wider relationship, community, and policy contexts. We therefore chart a multicomponent prevention strategy with HIV positive gay men across four domains: improving HIV diagnosis and care continuum participation; enhancing risk reduction through counseling and treatment of comorbidities; engaging partner-related strategies; and mobilizing communities and structural interventions. Like a table with four legs, efforts to address prevention with HIV positive gay men will be unsteady without one or more of these components. Substantial gaps in the research evidence base for such an approach remain, and must be addressed.