Communication and negotiation are not new subjects in HIV prevention research. Researchers were examining how partners negotiated safer sex as far back as the 1980s. What has changed profoundly is the reality in which those conversations take place. Today’s prevention options and ways of meeting partners are very different. This changed landscape is the focus of research by a team led by Prof. Dr. Daniel Gredig of the University of Applied Sciences and Arts Northwestern Switzerland. The team explores how HIV-negative men who have sex with men negotiate protection with non-steady partners today.

The research comes at a time when HIV prevention has become more flexible. Condoms remain an important tool to minimize the risk of HIV and reduce many other sexually transmitted infections. Alongside them, pre-exposure prophylaxis, or PrEP, allows HIV-negative people to take medication that provides highly effective protection against HIV. Equally significant is the knowledge that people living with HIV who receive successful treatment and maintain an undetectable viral load do not sexually transmit the virus. These developments have expanded the choices available.

Greater choice, however, also creates new challenges. Two people meeting for the first time may arrive with different expectations about how they wish to protect themselves. One may prefer condoms in every situation. Another may rely confidently on PrEP. A third person may combine several approaches, including regular testing and careful discussion with partners. None of these strategies is automatically right or wrong. What matters is how two people communicate when their expectations differ. This is where an established subject of HIV research takes on new significance in a transformed prevention environment.

To explore these questions, the research team interviewed twenty-nine HIV-negative men living in the German-speaking regions of Switzerland. Participants reflected on their experiences with casual partners and described how conversations about protection unfolded before and during intimate encounters. The team also used an innovative virtual reality exercise that stimulated participants’ memories and encouraged them to elaborate on situations they had not mentioned earlier in the interview. This helped the researchers understand not only what decisions were made, but how those decisions developed.

One of the study’s most valuable findings is that HIV prevention is rarely decided in a single conversation. Instead, it evolves over time. A person may first notice details in an online dating profile, continue the discussion through messages, and only reach a final agreement after meeting face to face. Each stage offers opportunities to ask questions, share information, and establish expectations. At the same time, every stage also creates opportunities for misunderstanding if assumptions replace open discussion.

Prof. Dr. Daniel Gredig and his colleagues identified seventeen different negotiation strategies used by participants. These strategies fell into three broad groups. Some focused on expressing personal boundaries clearly. Others leveraged sexual attraction or a partner’s arousal in order to get what they wanted. A third group centred on exchanging information about HIV prevention and perceived risk. Together, the strategies provide a detailed account of how communication and negotiation operate within the realities of contemporary HIV prevention.

Many participants described using direct communication whenever possible. They asked prospective partners whether they used PrEP, whether they preferred condoms, or whether they had recently been tested. These conversations often began through dating applications before any face-to-face meeting had taken place. Discussing expectations early allowed both people to understand whether their prevention preferences were likely to be compatible before becoming emotionally or physically involved.

Online dating has changed the way these conversations begin. Profiles frequently include prevention preferences, giving users an opportunity to share information before exchanging messages. Some mention PrEP, while others indicate that they prefer condoms or describe the encounters they are seeking. These details can influence whether someone begins a conversation at all. If the strategy indicated in a profile appears incompatible with their own, some participants may decide not to pursue a meeting. Yet profile information can be misinterpreted, so it cannot always substitute for direct discussion.

Communication was not always verbal. Some participants described placing condoms where they would be easily visible, allowing their presence to communicate expectations without requiring an immediate discussion. Others paid close attention to a partner’s reactions when protection was mentioned. Such signals could complement spoken conversations and sometimes contribute to a tacit agreement. The findings show that negotiation may occur through actions and context as well as explicit words.

The study also recognises that intimate encounters do not unfold in calm, clinical settings. Attraction, excitement, affection, and anticipation can all influence behaviour. Participants acknowledged that sexual arousal could affect discussions about protection, while some described attempts to use a partner’s arousal to achieve a preferred outcome. These immediate interpersonal dynamics are important, but the research team does not present them as a complete explanation for prevention decisions. Other research, including the team’s own work, has documented many additional factors that shape behaviour. The present findings add another layer to that broader understanding, showing how attraction and arousal can become part of negotiation between partners in the moment.

Importantly, the findings do not suggest that pleasure and protection are incompatible. Instead, they show that people often work to balance both. Some participants felt most comfortable relying on PrEP. Others consistently preferred condoms. Many adapted their behaviour according to the wishes of both partners, recognising that successful prevention depends upon reaching a shared understanding rather than insisting on a single universal approach.

As the research makes clear, scientific advances have provided remarkable new tools for preventing HIV, but they have not removed the need for conversation. If anything, greater choice has made communication even more important. Understanding another person’s expectations, expressing one’s own boundaries, and respecting differences have become essential skills. The study does not introduce communication as a new idea in HIV prevention. Rather, it examines how a long-established part of prevention operates in a world transformed by PrEP, effective treatment, online dating, and a wider range of choices.

The study also offers valuable insights into the role of trust. Trust is often spoken about as though it develops automatically through attraction or familiarity, but participants described something more practical. Trust could be built through openness. Asking questions about HIV prevention need not be an accusation or a sign of suspicion. Instead, such conversations can reflect respect for both partners and a shared commitment to making informed decisions together.

At the same time, the research reminds us that trust should never replace communication. Assuming that another person shares the same expectations can lead to misunderstandings, particularly when different prevention strategies are available. A partner who relies on PrEP may approach an encounter differently from someone who prefers condoms, even though both are taking their sexual health seriously. Open discussion can help ensure that neither person has to rely solely on assumptions.

Confidence also emerged as an important factor. Some participants found it easy to express their boundaries and explain the protection methods they preferred, while for others it could be more difficult. This highlights an important aspect of sexual health. Knowing the facts about HIV prevention is only part of the challenge. People also need the confidence and communication skills to put that knowledge into practice with another person.

The research team therefore argues that prevention should also be understood in interpersonal terms. Public health campaigns have traditionally focused on increasing knowledge about HIV transmission and encouraging particular behaviours while seeking to provide access to prevention measures such as condoms or PrEP and to remove structural barriers of protection behaviour or stigma. Those goals remain important, and communication has long been part of HIV prevention research and practice. The team’s findings add to this history by showing why communication skills continue to matter in today’s more complex prevention environment. Helping people discuss prevention openly, respectfully, and confidently can complement accurate information about how prevention methods work.

Digital technology adds another dimension to that picture. Dating applications have created new opportunities for people to communicate prevention preferences before meeting in person. They allow users to share information earlier than might once have been possible. Some participants made decisions based solely on information in a profile, choosing whether to begin chatting or pursue a meeting according to whether another person’s stated prevention strategy appeared compatible with their own. Yet online information can also be misunderstood, and a profile cannot capture every situation or guarantee that two people interpret the same words in the same way.

Perhaps the most powerful message emerging from the research is that communication can itself be a form of care. Taking time to ask questions, explain preferences, and listen to another person’s concerns can demonstrate respect as well as responsibility. These conversations may not always feel easy, and they do not eliminate the many other influences on sexual behaviour. What they can do is create better conditions for people to understand each other’s wishes and make informed choices.

The work of Prof. Dr. Daniel Gredig and the wider research team therefore contributes to a long-running conversation within HIV prevention. Its importance lies in showing what negotiation can look like under contemporary conditions. The prevention landscape has changed enormously since researchers first began examining safer-sex communication decades ago. The need to understand how people navigate that landscape together has changed with it.

Ultimately, the study presents a nuanced picture of modern HIV prevention. Scientific progress has expanded the choices available, allowing people to tailor prevention to their circumstances and needs. But medical innovation does not operate in isolation. People still have to interpret information, express preferences, respond to partners, and sometimes manage disagreement. The seventeen strategies identified by the team reveal just how varied those interactions can be.

That is why the idea of protection as a conversation remains so useful. It does not suggest that communication explains everything, nor that earlier generations of researchers overlooked negotiation. Instead, it captures one important element of a much larger reality. HIV prevention is shaped by medical possibilities, information, motivation, personal circumstances, social environments, desire, trust, and many other influences. Within that complex picture, communication helps people navigate the choices available to them.

More than forty years into the history of HIV, the context has changed almost beyond recognition, but the need to understand one another has not. Today’s conversations may involve PrEP, an undetectable viral load, dating profiles, condoms, testing, or combinations of strategies. The tools are newer and the choices broader, yet people still have to decide how those choices fit together when they meet. The research team’s contribution is to illuminate that process as it exists now, as an important part of a story that continues to evolve.