HIV Prevention Strategies for Sexual Minority Communities

HIV prevention among sexual minority communities encompasses a combination of biomedical, behavioural and structural approaches tailored to diverse risk profiles and social contexts. Biomedical strategies include pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), condoms and emerging long-acting formulations such as injectable antiretrovirals. Behavioural interventions promote regular testing, safer-sex negotiation skills and adherence support, often delivered through peer-led groups, digital platforms or telehealth services. Structural measures address stigma, discrimination and legal barriers by fostering inclusive policies, protecting against employment and housing discrimination, and ensuring culturally competent care. Community engagement remains central, with interventions co-designed alongside sexual minority individuals to enhance acceptability, trust and uptake. Globally, integrated service delivery models that combine clinic-based care with community outreach and mobile technologies have demonstrated promise in expanding access, particularly in resource-limited settings. Continuous monitoring of uptake and persistence, alongside novel surveillance methods, ensures that programmes adapt to emerging needs and evolving epidemic dynamics.

Research from Nature Portfolio

Recent work has begun to quantify the physiological impact of sexual behaviour stigma among men who have sex with men by measuring salivary cortisol in a large internet-based cohort. Findings indicate that experiences such as healthcare providers gossiping and law enforcement refusal to protect are associated with elevated morning and evening cortisol levels, linking external stigma to internal stress responses. This biosocial perspective underscores the need for stigma-reduction components within prevention programmes, suggesting that integrating stress biomarkers could guide personalised support and enhance engagement with testing and prophylactic services. Ongoing investigations aim to map how stress physiology interacts with adherence to PrEP and other preventive measures.

HIV Prevention Strategies for Sexual Minority Communities publication trend

The graph below shows the total number of articles in hiv prevention strategies for sexual minority communities across all publications each year (not limited to Nature Index journals).

Technical terms

Pre-exposure prophylaxis (PrEP): The use of antiretroviral drugs by HIV-negative individuals to prevent acquisition of HIV prior to exposure.

Post-exposure prophylaxis (PEP): A short course of antiretroviral treatment initiated within 72 hours of potential HIV exposure to prevent infection.

Combination prevention: The coordinated use of multiple interventions (biomedical, behavioural, structural) to reduce HIV transmission risk.

Telehealth: The delivery of health services and information via digital and telecommunications technologies, enabling remote consultations and follow-up.

Stigma: Social devaluation or discrimination against individuals based on perceived characteristics, such as sexual orientation or HIV status, which impedes access to care.

References

1. Agreements and Disagreements Between Professionals and Users About the Experience of a Telehealth Service for HIV Pre-Exposure Prophylaxis (TelePrEP): Qualitative Interview Study. Journal of Medical Internet Research (2025).
2. Telehealth effectiveness for pre‐exposure prophylaxis delivery in Brazilian public services: the Combine! Study. Journal of the International AIDS Society (2023).
3. Predicting salivary cortisol and sexual behavior stigma among MSM in the American Men’s Internet Survey 2019. Scientific Reports (2023).
4. A Multicomponent Intervention (POSSIBLE) to Improve Perceived Risk for HIV Among Black Sexual Minority Men: Feasibility and Preliminary Effectiveness Pilot Study. JMIR Human Factors (2024).
5. The current landscape of pre-exposure prophylaxis service delivery models for HIV prevention: a scoping review. BMC Health Services Research (2020).