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The following letter from TAG Executive Director, Mark Harrington, and Dr. Demetre Daskalakis, Deputy Commissioner of Disease Control at the New York City Department of Health and Mental Hygiene, to The New York Times was published on July 5, 2018.

Preventing HIV
July 5, 2018

To the Editor:

Re “The End of Safe Gay Sex?,” by Patrick William Kelly (Opinion Piece,, June 26):

Condoms work when used consistently. Men who have sex with men who cannot use condoms every time, or will not, should not be shamed and further alienated from strategies that prevent H.I.V. and promote sexual health.

Sexually transmitted infection control has to evolve to address a new world where antiretrovirals — taken by people living with H.I.V. as treatment or by H.I.V.-negative people as PrEP (pre-exposure prophylaxis) — can stop the spread of the virus.

The yearly number of new H.I.V. diagnoses in New York City has reached a low. This was achieved through PrEP and the increase of immediate H.I.V. treatment for those who received a diagnosis of H.I.V., in addition to the city’s sex-positive marketing campaigns. It was driven by the work of public health experts, not “PrEP enthusiasts.”

We must develop prevention strategies that align with human nature, not against it. If you tell someone that his sex life is no longer equated with illness and death, it is only to be expected that he will enjoy sex more.


Dr. Daskalakis, a doctor of infectious disease, is the deputy commissioner of disease control at the New York City Department of Health and Mental Hygiene. Mr. Harrington is the executive director of Treatment Action Group.

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