American journal of public health 2017 04 20() e1-e8 doi 10.2105/AJPH.2017.303704
In the 1970s, groups of gay and gay-allied health professionals began to formulate guidelines for safer sexual activity, several years before HIV/AIDS. Through such organizations as the National Coalition of Gay Sexually Transmitted Disease Services, Bay Area Physicians for Human Rights, and the Sisters of Perpetual Indulgence, these practitioners developed materials that would define sexual health education for the next four decades, as well as such concepts as "bodily fluids" and the "safe sex hanky." To do so, they used their dual membership in the community and the health professions. Although the dichotomy between the gay community and the medical establishment helped define the early history of HIV/AIDS, the creative work of these socially "amphibious" activists played an equally important part. Amid current debates over preexposure prophylaxis against HIV and Zika virus transmission, lessons for sexual health include the importance of messaging, the difficulty of behavioral change, and the vitality of community-driven strategies to mitigate risk. (Am J Public Health. Published online ahead of print April 20, 2017: e1-e8. doi: 10.2105/AJPH.2017.303704).