Leaving safety at the bedroom door.

The message from the first National HIV Prevention Conference, held August 29-September 1 in Atlanta, was sobering and direct: Large numbers of gay men continue to engage in unsafe sex and, in turn, become infected with HIV.

"The perception that the epidemic is over for gay men couldn't be further from the truth," said Ronald O. Valdiserri, conference cochair and deputy director of the National Center for HIV, STD, and TB Prevention.

Data presented in Atlanta suggest that the majority of the approximately 40,000 new infections every year are among African-Americans, especially young gay men and heterosexual women. One California-based study of 2,638 gay men age 13-19 who were seeking HIV tests found that African-American men were at 5.8 times greater risk for infection than other young gay men. Meanwhile, a seven-city study of 3,492 gay men age 15-22 found that 41% had engaged in unprotected anal intercourse in the past six months.

Pushing the tide toward unprotected sex are the powerful new drug therapies, researchers said at the conference, which was organized by the Centers for Disease Control and Prevention. A West Hollywood, Calif., study found that the more optimistic gay men were about AIDS treatments, the less likely they were to use condoms, abstain from anal sex, or to limit their number of sex partners. Of the men surveyed who are HIV-positive, those who were optimistic about drug therapies used condoms only 66% of the time they had sex.

"We can't go soft on prevention," Valdiserri said. "We actually need prevention more today now than we ever have before."