Over 40,000 people are now living with diagnosed HIV in the UK. The term 'positive prevention' has been coined to describe HIV prevention that focuses on people living with an HIV diagnosis. There is uncertainty, however, about how people with HIV
manage risk and how their ability to prevent the transmission of HIV is specifically linked to mental health and social circumstances. We analysed 44 individual and 3 group interviews with the people most affected by HIV in the UK: black African
heterosexual men and women and gay men (mostly white). We found that participants had similar as well as contextually different needs when it came to negotiating safe sex, assimilating prevention knowledge and establishing positive mental health. The themes that emerged included taking 'additional responsibility' for partners,
negotiating with partners who are willing to have unprotected (anal or vaginal) sex, links with mental health, constructing the moral 'other' and power differences. We conclude with a discussion of the priorities for positive prevention for men and women living with diagnosed HIV in the UK.