In response to these alarming health disparities among gay and bisexual men, there has been a call to broaden the prevention lens to examine the influence of multiple social and contextual factors influencing health behaviors (Halkitis & Cahill, 2011). Yet even these medical advances are fraught with their own complications, not least of which are matters of uptake and adherence. In this biomedical approach, the early detection and treatment of HIV have been recommended policy for the last several years (CDC, 2006 Workowski & Berman, 2006) as a way to decrease community viral load.
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More recently, with the game-changing breakthroughs in the biomedical arena, attention has shifted to these biomedical prevention strategies, which include preexposure prophylaxis (PrEP) for gay, bisexual, and other MSM (Grant et al., 2010) and vaginal microbicides for women (Abdool et al., 2010). In fact, gay, bisexual, and other MSM acquire HIV at rates 44 times greater than other men and 40 times greater than women (CDC, 2011a). In addition, the population of men who have sex with men (MSM) has continued to be the only risk category for which new infections are rising (Hall et al., 2008). These approaches, rooted primarily in social-cognitive frameworks (Halkitis, 2010b), have resulted in maintaining new infections in the United States at a steady state for the last decade (Centers for Disease Control and Prevention, 2011b). Over the last 30 years, efforts to prevent new HIV infections among gay and bisexual men have been guided by paradigms that hold individuals responsible for their health behaviors.
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