There is increasing recognition that gay men and other men who have sex with men (MSM) throughout the world -- in developed and developing countries alike -- have very high, disproportionate rates of HIV.Gay men and other MSM in developing countries remain largely under-represented and often completely invisible in national HIV and AIDS strategies, epidemiology, surveillance, and research; and they are woefully under-served by prevention, care, support, and treatment programmes.Anal sex between men and women is under-recognised, under-researched and undercharacterised, resulting in a pressing need to address the attendant HIV prevention issues.While rectal microbicide research efforts continue, other viable options should be pursued aggressively to prevent transmission of HIV and other sexually transmitted infections through anal intercourse and to promote better anal health. For example: provision of male and female condoms, water-based lubricants, and human papillomavirus (HPV) vaccination