A lot of talk about PrEP this week. PrEP is short for Pre-Exposure Prophylaxis. It is a new HIV prevention method in which people who do not have HIV take a daily pill to reduce their risk of becoming infected. When used consistently, PrEP has been shown to be effective in men who have sex with men (MSM) and heterosexual men and women. A CDC study is also underway to evaluate whether PrEP is safe and effective in reducing HIV infection among injection drug users, but those results are not yet available.

Much more needs to be learned about the safety and effectiveness of PrEP in the real world. Demonstration projects are designed to gather information on safety, efficacy and program design for new interventions. They help guide subsequent larger-scale introduction. Such projects are planned or underway for the US, Kenya, Nigeria and Uganda.

Looking forward to seeing the results of these studies in 2014 in Melbourne.

Youth-adult partnerships and programs are an innovative way of involving young people in HIV prevention efforts. They are based on the understanding that young people have a right to participate in programs that affect them and on the experience that programs are more sustainable and more effective when youth are treated as partners. Because youth are often less powerful, articulate and knowledgeable than their adult partners, youth-adult partnerships would focus on the empower young people to make their voices heard.

Women are disproportionately affected by HIV. But work is being done to aggressively change the epidemic for women including mother to child transmission. In some societies, women have few rights within sexual relationships and the family. Often men make the majority of decisions, such as whom they will marry and whether they will have more than one sexual partner. This power imbalance means that it can be more difficult for women to protect themselves from getting infected with HIV. Furthermore, a woman may not be able to insist on the use of a condom if her husband is the one who makes the decisions.

Marriage does not always protect a woman from becoming infected with HIV. Many new infections occur within marriage or long-term relationships as a result of unfaithful partners. In a number of societies, a man having more than one sexual partner is seen as the norm.

A considerable sustained effort in addressing the substantial rates of HIV has become supreme to having an impact on the current state of the AIDS epidemic for Black MSM. The leadership and experiences of Black gay men have been useful in the articulation of the marginalization in our communities. Work in this area has helped us to better understand the impact of the AIDS epidemic as situated in our everyday lived experiences. Study results released yesterday by the HPTN (a study I worked on as a research assistant for three years) showed disturbing rates of new HIV infections occurring among young black MSM. Even more alarming, HPTN 061 found that young black MSM—those 30 years of age and younger—acquired HIV infection at a higher rate per year, three times the rate among U.S. white MSM.

So how do black gay men navigate this conference with the biomedical theme that treatment is prevention?

There are spaces such as the Black AIDS Institute booth, Caribbean zone, People Living with HIV zone, Black Diaspora zone, and the LGBT spaces to reflect our diversity but how do you build a collective movement for black gay men that is representative of our fragmented and unique experiences with the multiple intersections of identity and complexities that black gay men experience

Where should our place be? Would a black gay men’s zone be an important resource at the next conference in Melbourne Australia for our communities? How does the experience of a black gay men in AUS related to the experience of a brotha living in Oakland where there an equally high prevalence rate.

Focus on young black gay men in the epidemic - how do we build bridges and provide support for black gay men already infected, aging with HIV. Further analysis of data from the study is ongoing to assess how HIV risk among black MSM might be affected by childhood experiences, social and sexual networks, discrimination, homophobia, incarceration and barriers to health care. These findings will help inform future research and prevention efforts. The second area of commitment will be through community and organizational development, meaning broadening a base of support in the community; interacting with the community to bring new issues, opportunities and community needs to the attention of organizations; maintaining accountability to the public, funders, and members.

Thirty years after the first mentions of HIV, the United States is still one of the hardest impacted countries in the world. Closer to home Young Black Gay Men bear the brunt of the epidemic. According the data released by the Centers for Disease Control and Prevention in 2011, the MSM population has continued to show the only increase in incidence data, specifically a 48% increase between 2006 – 2009. Why the increase? From a young Black Gay Man perspective: 1) access to culturally competent HIV services. 2) culturally congruent research 3) addressing the whole man are all some of the myriad issues that plague YBMSM. We are now the face of the epidemic and it is important that we begin to be empowered to handle our sexual identities and practices that protect us against this devastating disease.

YBMSM are experiencing sexual debate at earlier ages and are often marginalized not only within the gay communities but within the African American community as a whole.