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Some pathologize those who take sexual risks as being self-destructive,
suicidal, damaged individuals. Savage (1999) suggested that “for some
gay men, danger is a permanent fetish” Others condemn the
judgmental culture as once again wanting to cast gay desire and gay
sexuality as sick and perverse.
At this point it will be useful to clarify some terms. Many people use
the phrases “unprotected” and “unsafe” sex interchangeably. This is inaccurate
and confusing. Unsafe sex refers to when an HIV-negative man
has UAI with either a partner of unknown HIV status or with a partner
he knows to be HIV-positive, thus opening the possibility of HIV transmission
and new infection. Unprotected sex is anal intercourse without
a condom between two HIV-negative men. Monogamous male–male
relationships where both partners know that they are HIV-negative are
not at risk for transmission of HIV even if they do not use condoms,
provided that they have sex only with each other or only have safer sex
with any outside sexual partners. “If there is no virus or other pathogen
to transmit, the sex is not unsafe”. These men
obviously trust each other to sustain sexual fidelity. The “if ” of “if they
have sex only with each other” is a very big one.
Originally, social scientists
used the term “barebackers” to refer to men
who intentionally seek out condomless anal sex, as distinct from men
who have UAI due to poor planning or accidents. Some
write that for a behavior to be barebacking two crucial
criteria must be met: intentionality, and the potential for the risk of
viral transmission. Researchers often hear people say that there are
many situations in which sex without condoms is not barebacking. If
people in a monogamous couple where both are HIV-negative do not
use condoms, most do not describe this as barebacking. Similarly, people
who get caught in a moment of passion and once in a blue moon have
unintentional unprotected sex, or who have sex with condoms but they
break, or people who were drunk one night and did not use a condom
are not said by the above researchers to engage in bareback sex.
As barebacking has become more prevalent in the gay community,
the perception and definition of it has evolved. “Whereas the term
originally was used to describe engaging in premeditated, consciously
chosen unprotected anal sex, it has now been incorporated into colloquial
discussions to describe the unintentional, unprotected ‘slip-ups’
that occur”). Halkitis, Greene, and Mourgues
(2005) discuss that among a sample of New York gay men there is a wide
variety of meanings given to and understandings of the ways that the
term barebacking is used. Mansergh and colleagues (2002) propose defining
the term “barebacking” (for both HIV-negative and HIV-positive
men who have sex with men [MSM]) as “intentional anal sex without a
condom with men who are not a primary partner (that is, not someone
the individual lives with or sees often and to whom the individual feels
a special emotional commitment)”
There is evidence that sex without condoms is the relatively infrequent
act of a relatively large number of gay men (rather than the very
frequent act of a few) and that it is often moderated by relationship
status as well as HIV status (Coxon & McManus, 2000). Despite the
risks — or perhaps because of the risks — it holds a certain mystique in
some segments of a community that had to learn to be afraid of sex all
over again. One does not have to look very hard to find Internet sites
devoted to the glorification of barebacking. A walk through a gay sex
club may reveal men openly engaging in barebacking.
It is important to state and to reiterate, that even anal sex with a
condom is not 100 percent risk free for preventing HIV transmission.
Condoms may have a tear or hole in them; they are often incorrectly
used and can break.
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