Although at the global level the incidence of HIV has declined there are contrary trends gaining momentum. Unimpressed by public prevention campaigns certain groups belonging to the 'at-risk' population are engaging in risky sexual behaviour and concomitant misuse of illicit drugs thereby potentiating the odds of spreading HIV and other sexually transmitted infections (STIs). The blending of drug misuse with substantial risky sexual behaviour increases those risks and creates an almost inseparable complexity. Group-sex settings of this kind are partly organised via national and international social networks. Those people engaged in this modern trend mostly present with various health impairments thereafter, such as unconsciousness or confusion, often rendering them unable to adhere to combined antiretroviral therapy (cART) if they are HIV-infected. These people staunchly refuse to cooperate with prevention messages. Thereby public prevention efforts to curb the spread of HIV are largely wasted. But it is not just the individual's issue; if developments of this kind are not contained serious challenges with HIV and other STIs might arise for these communities. Key words: HIV, prevention concepts, barriers, psychotropic drugs
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