Behavior change is very difficult, even when the stakes are high. Despite all that we know about the dangers of tobacco, millions continue to smoke. We also know that we should exercise and eat well, yet obesity is on the rise. We’ve got the same struggles when it comes to HIV prevention and sexual health.
Until now, adopting safer behaviors—including condom use—has been the only option available for people who wished to protect themselves from becoming infected. Lots of people were able to successfully change their behavior in the late 1980s and early 1990s, so much so that the rate of new infections dropped by an amazing degree. Since then, however, helping people maintain safer behaviors or getting younger people to adopt them has gotten a lot harder. In fact, more than 50,000 people are estimated to have become infected each year since the mid- to late-1990s. That’s about 800,000 new infections since then. Among gay and bisexual men, new cases are actually on the rise, especially for young black and Latino men.
And it’s not just individual behaviors that put people at risk for HIV. There are many external factors that contribute, too. These include poverty, homophobia, racism, homelessness—all of these things can significantly increase HIV risk while also contributing to significant health disparities across various racial and socio-economic groups.
We desperately need new tools in order to turn things around. PrEP is a new HIV prevention strategy that puts the power of prevention in the hands of HIV-negative people. Now that PrEP has been shown to be effective in clinical trials, the next step is to determine whether and how PrEP can be used to reduce HIV infections in communities.