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Incorporating Couples-Based Approaches into HIV Prevention for Gay and Bisexual Men: Opportunities and Challenges

  • Special Section: Sexual Health in Gay and Bisexual Male Couples
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Abstract

Thirty years after the beginning of the HIV epidemic, gay, bisexual, and other men who have sex with men (collectively called MSM) bear a disproportionate burden of HIV in the United States and continue to acquire a distressingly high number and proportion of new infections. Historically, HIV prevention for MSM has been focused on individual-level behavior change, rarely intervening with MSM as part of a couple. Yet, an estimated 33–67 % of HIV infections among MSM are acquired from primary sexual partners, suggesting that work with MSM as couples could be an important contributor to prevention. Given the emergence of high impact combination HIV prevention, it is timely to consider how work with the broad variety of male couples can improve both personal and community health. Couples HIV testing and counseling for MSM is an important advance for identifying men who are unaware that they are HIV-positive, identifying HIV-discordant couples, and supporting men who want to learn their HIV status with their partner. Once men know their HIV status, new advances in biomedical prevention, which can dramatically reduce risk of HIV transmission or acquisition, allow men to make prevention decisions that can protect themselves and their partners. This paper highlights the present-day challenges and benefits of using a couples-based approach with MSM in the era of combination prevention to increase knowledge of HIV status, increase identification of HIV discordant couples to improve targeting prevention services, and support mutual disclosure of HIV status.

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Acknowledgments

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Division of HIV/AIDS Prevention (MS D-21), Centers for Disease Prevention and Control, 1600 Clifton Road, Atlanta, GA, 30333, USA

    David W. Purcell, Yuko Mizuno, Dawn K. Smith, Kristina Grabbe & Hank Tomlinson

  2. Division of Global HIV/AIDS, Centers for Disease Prevention and Control, Atlanta, GA, USA

    Cari Courtenay-Quirk

  3. National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Prevention and Control, Atlanta, GA, USA

    Jonathan Mermin

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  1. David W. Purcell
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  2. Yuko Mizuno
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  3. Dawn K. Smith
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  4. Kristina Grabbe
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  5. Cari Courtenay-Quirk
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  6. Hank Tomlinson
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Correspondence to David W. Purcell.

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Purcell, D.W., Mizuno, Y., Smith, D.K. et al. Incorporating Couples-Based Approaches into HIV Prevention for Gay and Bisexual Men: Opportunities and Challenges. Arch Sex Behav 43, 35–46 (2014). https://doi.org/10.1007/s10508-013-0205-y

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