Context is Everything

SUMMARY

As we approach the third decade of AIDS, HIV prevention in the United States confronts expanding public concern about continuing infections among gay men. This paper provides a brief history of HIV prevention efforts among gay men in the United States, as well as a succinct analysis of its successes and failures. By focusing on lessons learned from work in the 1980s-as well as lessons which have not yet' been learned-the author suggests future directions in HIVprevention for gay men which emphasize critical analysis of epidemiological trends, and countering the merging of gay identity with HIV infection. Supporting men to gain greater authority and responsibility¹ for their sexual community-building and redevelopment is necessary for lowering the infection rate among successive generations of gay men.