Indeed, the data we have collected suggests the need for a fresh approach to the design and implementation of effective HIV prevention work in public sex environments. It is essential to have a clear focus on why the work needs to be done in order to develop specific and functional objectives, targets and ultimately outcomes which are relevant to HIV prevention. Although levels of risk at PSEs are probably lower than on the gay scene, nevertheless it is clear that PSEs are sites of sexual encounter which need also to be targeted for that reason. Ironically, although in the past PSE projects have been presumed to be a way of reaching particular demographic subsections of the population, in reality, our findings suggest, they are quintessential sites of sexual mixing offering a real opportunity for sexual targeting of interventions. Our findings show that PSE sites are also sites of temptation and risk.
Unsafe sex does regularly occur.
Establishing a safety net of triggers and reminders to promote community norms in favour of safer sex is no less important in PSEs than in commercial gay venues. Reviews of the scientific effectiveness literature have indicated that the most effective forms of HIV prevention are likely to involve peer educators in community settings. There appears to be a potential to nurture and develop the goodwill of the PSE-using population for peer education and support. Specifically, we would make the following recommendations about what the evidence suggests would be more effective models of working. This section combines the conclusions from the findings contained in this report as well as the conclusions from the accompanying literature review, Blind Spots.