The complex realities of primary prevention for HIV infection in a "just do it" world

Primary prevention of HIV requires behavior changes to decrease the risk of sexual, drug using, and occupational exposure to infection. The difficulties associated with behavior change are related to social, cultural, and political constraints that reinforce heterosexism, sexism, and racism. These problems are compounded by concurrent epidemics of violence, poverty, and drug use, and are made more difficult by the absolutist mentality. Use of theory-based interventions, awareness of community attributes, and a change to pragmatic political agendas can help in the development of effective prevention programs.