HIVAND TECHNOLOGY (J SIMONI AND K HORVATH, SECTION EDITORS) The Roles of Technology in Primary HIV Prevention for Men Who Have Sex with Men Patrick S. Sullivan 1 & Jeb Jones 1 & Nishant Kishore 1 & Rob Stephenson 2 Published online: 30 October 2015 # Springer Science+Business Media New York 2015 Abstract Men who have sex with men (MSM) are at dispro- portionate risk for HIV infection globally. The past 5 years have seen considerable advances in biomedical interventions to reduce the risk of HIV infection. To be impactful in reduc- ing HIV incidence requires the rapid and expansive scale-up of prevention. One mechanism for achieving this is technology-based tools to improve knowledge, acceptability, and coverage of interventions and services. This review pro- vides a summary of the current gap in coverage of primary prevention services, how technology-based interventions and services can address gaps in coverage, and the current trends in the development and availability of technology-based pri- mary prevention tools for use by MSM. Results from agent- based models of HIV epidemics of MSM suggest that 40– 50 % coverage of multiple primary HIV prevention interven- tions and services, including biomedical interventions like preexposure prophylaxis, will be needed to reduce HIV inci- dence among MSM. In the USA, current levels of coverage for all interventions, except HIV testing and condom distribu- tion, fall well short of this target. Recent findings illustrate how technology-based HIV prevention tools can be used to provide certain kinds of services at much larger scale, with marginal incremental costs. A review of mobile apps for pri- mary HIV prevention revealed that most are designed by non- academic, nonpublic health developers, and only a small pro- portion of available mobile apps specifically address MSM populations. We are unlikely to reach the required scale of HIV prevention intervention coverage for MSM unless we can leverage technologies to bring key services to broad cov- erage for MSM. Despite an exciting pipeline of technology- based prevention tools, there are broader challenges with funding structures and sustainability that need to be addressed to realize the full potential of this emerging public health field. Keywords Men who have sex with men . Technology . HIV prevention Introduction Men who have sex with men (MSM) represent less than 2 % of the US population [1] but account for about two thirds of new HIV diagnoses annually [2]. Primary HIV prevention for MSM is challenging because of the high biological risk of HIV transmission through anal intercourse not protected by condoms [3, 4], stigma, and discrimination [5–7] which can result in decreased willingness to access prevention services, imperfect knowledge of HIV serostatus by MSM living with HIV [8], and a prominent role of transmission Bbursts,^ in which infections arising from acutely and recently infected men play a key role [9]. Because of these challenges to HIV prevention, there is growing consensus that a comprehensive package of prevention services will be required to meaning- fully reduce HIV incidence among MSM [10]. A comprehen- sive primary prevention package will include access to basic prevention services, such as HIV and STI testing, This article is part of the Topical Collection on HIV and Technology Electronic supplementary material The online version of this article (doi:10.1007/s11904-015-0293-5) contains supplementary material, which is available to authorized users. * Patrick S. Sullivan pssulli@emory.edu 1 Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA 2 Department of Health Behavior and Biological Sciences, School of Nursing and The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA Curr HIV/AIDS Rep (2015) 12:481–488 DOI 10.1007/s11904-015-0293-5