ABSTRACT
This chapter focuses on two problematic cases in different areas of AIDS service provision. It explores how the planning and prioritisation of HIV prevention interventions often fails to take account of the realities of the epidemic as revealed by epidemiological science. The chapter also focuses on primary HIV prevention work, a field in which the gap between science and service provision has been horrifying. Out of 226 agencies with an HIV prevention remit, two-thirds reported that they had never undertaken any kind of work with gay men, even though all had targeted heterosexuals. In early 1994 the Health Education Authority commisioned an updated survey of HIV prevention priorities in the UK, which revealed that a dramatic shift had taken place in a period of just two years: no fewer than 86% now reported work targeting gay or bisexual men. It is long overdue for this kind of rational approach to service planning to be extended to HIV prevention work.
