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[...]another African President admits that there have always been gay people in Africa and that such people were not systematically persecuted.11 Second, African governments reject anti-homophobia campaigns as the imposition of the wills of former colonial masters.12 However, there is evidence that prohomophobia campaigns have been supported by actors from developed countries-for example, public debate on the Ugandan anti-gay bill revealed moral and other support from US elements.13 As late as 2004, the US President's Emergency Plan for AIDS Relief (PEPFAR) supported anti-gay operations working under the guise of faith-based organisations providing abstinence-only programming.14,15 Africa has become a battleground for developed countries' socalled cultural wars, and it is ironic that discrimination that would be illegal in a developed country should be promoted elsewhere.

Despite the expansion of HIV prevention and treatment services across sub-Saharan Africa, new HIV infections remain stubbornly high [ 1]. In December of 2005, following a series of high-profile arrests made under anti-sodomy law, a Cameroonian newspaper published a list of “The Top 50 Presumed Homosexuals in Cameroon,” inciting explosive public discussion about same-sex sexuality [ 7]. [...]in addition to channelling resources from organizations to individuals, peer educators continually collect information about the needs of clients.

As the HIV field evolves to better serve populations which are diverse in risk and access to services, it is crucial to understand and adapt the conceptual tools used to make sense of the HIV pandemic. In this commentary, we discuss the concept of general population. Using a synthetic and historical review, we reflect on the genesis and usage of the general population in HIV research and programme literature, pointing to its moral connotations and its impact on epidemiologic reasoning. From the early days of the HIV pandemic, the category of general population has carried implicit normative meanings. General population represented those people considered to be undeserving of HIV acquisition, and therefore deserving of a response. Framing the HIV epidemic in sub?Saharan Africa as a generalized epidemic primarily affecting the general population has contributed to the exclusion of men who have sex with men from epidemic responses. The usage of this category has also masked heterogeneity among those it includes; the increasing focus on the use of interventions such as circumcision and HIV treatment as general population HIV prevention approaches has been marked by a lack of attention to heterogeneity among beneficiaries. We recommend that the term general population be retired from the field?s lexicon. HIV programmes should strengthen their capacity to describe the heterogeneity of those they serve and plan their interventions accordingly. To increase the efficiency and impact of the HIV response, it is urgent to stratify the category of general population by risk. Sexual networks are a promising basis for this stratification.

Introduction As the HIV field evolves to better serve populations which are diverse in risk and access to services, it is crucial to understand and adapt the conceptual tools used to make sense of the HIV pandemic. In this commentary, we discuss the concept of general population. Using a synthetic and historical review, we reflect on the genesis and usage of the general population in HIV research and programme literature, pointing to its moral connotations and its impact on epidemiologic reasoning. Discussion From the early days of the HIV pandemic, the category of general population has carried implicit normative meanings. General population represented those people considered to be undeserving of HIV acquisition, and therefore deserving of a response. Framing the HIV epidemic in sub‐Saharan Africa as a generalized epidemic primarily affecting the general population has contributed to the exclusion of men who have sex with men from epidemic responses. The usage of this category has also masked heterogeneity among those it includes; the increasing focus on the use of interventions such as circumcision and HIV treatment as general population HIV prevention approaches has been marked by a lack of attention to heterogeneity among beneficiaries. Conclusions We recommend that the term general population be retired from the field’s lexicon. HIV programmes should strengthen their capacity to describe the heterogeneity of those they serve and plan their interventions accordingly. To increase the efficiency and impact of the HIV response, it is urgent to stratify the category of general population by risk. Sexual networks are a promising basis for this stratification.