Safe sex fatigue, treatment optimism, and serosorting: new challenges to HIV prevention among men who have sex with men.

As the HIV epidemic enters its third decade in the United States, there have been few changes in the demographics of the populations most affected by HIV. Twenty years of HIV has resulted in changing attitudes toward prevention and infection in the population of men who have sex with men (MSM). This article presents a review of the recent research regarding HIV risks and attitudes among MSM and reports on several trends that have repeatedly emerged from the literature. Concepts such as safe sex, treatment optimism, and serosorting have recently become common among MSM communities and present a challenge to all who work in HIV prevention. Suggestions are made regarding implications for nursing and areas for future research.