Objectives. Since young gay men are engaging in alarmingly high rates of unsafe sex and few seek help for changing risky behaviors, community-level-programs to prevent infection with the human immunodeficiency virus (HIV) among them are urgently needed. Methods. We developed and implemented a community-level HIV prevention program in a midsized Oregon community. The peer-led program had three components: outreach, small groups, and a publicity campaign. Independently from the prevention program a cohort of young gay men (n = 300) was surveyed in this and in a similar comparison community pre- and postintervention. Results. Following intervention: the proportion of men engaging in any unprotected anal intercourse decreased from 41.0% to 30.0% (-27% from baseline), decreased from 20.2% to 11.1% (-45% from baseline) with nonprimary partners, and decreased from 58.9% to 44.7% (-24% from baseline) with boyfriends; No significant changes occurred in the comparison community over the same period. Conclusions. This prevention approach effectively led to HIV risk reduction. To reach risk-taking young gay men, HIV, prevention activities must be embedded in social activities and community life.
