A potent cocktail of celebrity, power, and wealth dominated discussions Monday at the International AIDS Conference in Vienna.

Former US President Bill Clinton urged patience in efforts to achieve universal HIV treatment access in the wake of the economic crisis.  Billionaire philanthropist Bill Gates called for greater efficiency responding to global AIDS and pop icon Annie Lennox warned of the destabilizing impact of millions of untreated HIV-positive mothers across the developing world.

But the 20,000 assembled delegates flirted with more than just stardom.  Noting that travel and conferences can be dis-inhibiting for some people, sexual health advocates deployed a guerrilla poster campaign on the Messe Wien conference center to raise participants’ consciousness of their own sexual health.

“We talk about mobile populations as being vulnerable to HIV, but you look around here and everyone is away from home, traveling and in situations where they might need safer sex education,” said Netherlands-based Krissy Ferris of the Pleasure Project.

A grassroots education and mobilization effort, the Pleasure Project promotes a range of safer sexual behaviors including fantasy, kissing, and masturbation.  The group trains healthcare professional on sexual health counseling and has encouraged porn producers to model erotic, safer behaviors.

Navigating sexual desire, encounters, and relationships in a world with HIV/AIDS was the topic of several sessions.  In one such presentation, British researchers described barriers to greater adoption of risk-reduction among HIV-positive gay men who engage in unprotected anal intercourse.  Most men surveyed viewed condoms as highly effective barrier methods but expressed reluctance about other harm-reduction strategies such as sero-concordant sex, not assuming the insertive position, refraining from anal sex altogether, or recommending post-exposure prophylaxis to partners who might need it. 

Study authors concluded that greater education and skills would be needed for wider adoption of sexual harm-reduction among the cohort.

“It wasn’t that they were planning to use these strategies [sexual harm reduction] in order to reduce risk, it’s that they used their understanding of them to make sense of the risk they had already taken,” said Adam Bourne of London-based Sigma Research. “Risk reduction rationalisations are a way of trying to reconcile the impact of behaviours with their potential outcomes, which may present discomfort when thinking back on it.”

To better manage risk, men must come to terms with and evaluate the risks involved in the sex they are having, study authors said. 

The desire for new preventive options for use during vaginal intercourse grew stronger as news spread about the clinical trial findings, which demonstrate that effective microbicides can be developed from antiviral medications.  Perhaps the most significant scientific finding of the conference, the news will accelerate the field of microbicide research and bring new hope to the fight against HIV/AIDS.

“It seems that pleasure has caught on within AIDS work,” Krissy said. 

See the video interview with The Pleasure Project.