Several of these factors together with many other issues might contribute to the noted increases in sexual risk behavior among MSM (McKirnan et al., 1996; Suarez and Kauth, in press). We must better understand the contextual issues that drive risk behavior if we are to develop more effective and humanistic prevention interventions (Odets, 1994, 1996). If not, we are in danger of erasing the substantial prevention gains of the past.