A lot has changed in the world of HIV/AIDS since I last attended an international conference, Montréal in 1989. The overwhelming majority of those affected by AIDS are now heterosexual women and men, or children. The days when AIDS was a “gay disease” are long gone.

Of the 22 million people dead from AIDS, less than 1 million have been gay men – still an appalling death toll, but only a small part of the total.

This is reflected in the Conference proceedings. There are plenty of gay men here, some of whom, like me, have been working in AIDS for nearly 20 years. But we are now vastly outnumbered by health workers, community activists and people with HIV from the developing world, nearly all of them heterosexual.

Most of these people have no memory of the first decade of the epidemic, which was dominated by heated debates about homosexuality, and even a debate about whether there was any such thing as heterosexual transmission of HIV. This seems a rather grim joke today, when 3 million people a year are dying of heterosexually transmitted AIDS.

Today the heterosexual world has almost full possession of HIV/AIDS. It is the overwhelming need to find a way of stopping the heterosexual epidemic that is driving research into new therapies, from which, paradoxically, gay men in the rich world are at the moment the main beneficiaries.

It used to be said that the coalition against AIDS consisted of “gay men and straight women” – heterosexual men wouldn’t touch AIDS because they were afraid of being tagged as gay.

Today this has radically changed. AIDS is so overwhelmingly a heterosexual disease that the great majority of those engaged in AIDS activism are straight.

As one of the gay men working here at Barcelona, I would be unhappy if the concerns of gay men dropped entirely off the agenda. But I am more than happy to find an environment in which heterosexual women and men, mainly from developing countries, are taking the leading roles.

Adam Carr