have found broadly similar trends, with more cases of HIV occurring in the recent era, particularly among PEP users. The Dutch researchers found that some MSM requesting PEP presumed that they were HIV negative but rapid testing revealed that they were in fact HIV positive. This finding suggests that they had been infected prior to their most recent episode of unprotected sex. This underscores the need for sexually active adults to get frequent HIV tests if they are having unprotected intercourse. The trend of increasing HIV infections in both the ACS and the PEP study indicates that high-risk behaviours are continuing in the present era when ART is widely available and that simply prescribing PEP to people is not sufficient to halt the spread of HIV over the long term. What is to be done? The Dutch researchers call for "a combination of more comprehensive preventive strategies," including counselling, for MSM who engage in unprotected intercourse. In another study where men who were exposed to HIV were given counselling and PEP, 77% of participants reported a decline in unprotected sex after counselling. The men in the present study who engaged in unprotected intercourse may also be good candidates for pre-exposure prophylaxis (PrEP) should this intervention become available.