PURPOSE OF REVIEW: HIV epidemic spread continues among gay, bisexual, and other MSM globally in 2013. These epidemics are occurring in rapidly shifting contexts among these men, which have important impacts on HIV spread, HIV programs, access to services and human rights. Current HIV prevention strategies are inadequate and are taken to insufficient scale to control HIV spread. RECENT FINDINGS: We reviewed recent reports on epidemiology, HIV prevention advances, human rights, and epidemic disease control among MSM to understand why HIV epidemics among these men remain poorly controlled. Network level factors appear to be critically important for HIV epidemic spread among MSM. The only new prevention technology with evidence for efficacy in this population, daily oral chemoprophylaxis (PrEP), has been little used, particularly in low and middle-income countries. SUMMARY: Much more vigorous prevention efforts are required, including the adaptation and expanded use of PrEP, if we are to reduce new infections among gay, bisexual and other MSM.