The efficacy of PEP for exposures apart from the health care setting needs to be determined. This determination presents significant ethical and practical challenges. For example, the chance of infection after any one exposure, especially if the HIV status of the source patient is unknown, is very low. Several studies documented that some gay men are more willing to engage in high risk behaviors because of their perception that effective treatments for HIV exist. A CDC study of young gay men suggested the belief that peers were also having risky sex may play a role in increased risk taking.
Prevention remains an arduous challenge.
The rate of annual new HIV infections in the U.S. has stabilized at approximately 40,000 new infections. The disease has become endemic to pockets of injection drug users, gay men, women and youth. Unfortunately, not all of the brilliance assembled in Geneva can solve these problems.