HIV/AIDS Issue: Barebacking Gay Sex

With the recent increase in barebacking, we can expect to see an increase in the rates of HIV and other STDs. In fact, we are already seeing an increase in the rate of gonorrhea specifically among gay men (although the overall rate is going down in other population groups). In addition, with the increase in barebacking, we are now also expecting to see a second wave of HIV infections in the gay community, unless interventions are quickly taken to prevent this from occurring.

Barebacking is an extremely controversial and complicated issue, especially since it is dealing with human behavior. Not all gay men engage in barebacking. Many gay men use condoms every time they have anal sex with every partner. But some gay men prefer to have unprotected anal sex and they are willing to take the risks.

For some gay men, the benefits of unprotected anal intercourse (intimacy, pleasure, etc.) outweigh the risks (HIV and other STDs). On the other hand, if two gay men have unprotected anal intercourse, and neither of them is infected with HIV, nor any other STD, then barebacking would be completely safe as far as infectious diseases are concerned. But if either partner has HIV or another STD, then there are significant risks of infection for these diseases through barebacking. Future HIV and STD prevention efforts targeted toward the gay community must incorporate the issue of barebacking.

The term barebacking generally refers to gay men engaging in unprotected anal intercourse. Barebacking has both its benefits and its drawbacks:

The Benefits of Barebacking:

1. Barebacking simply feels better, it's more enjoyable and more pleasurable, than protected anal intercourse.
2. Barebacking leads to greater intimacy between men during intercourse.
3. Barebacking is more spontaneous than protected sex. There is no need to bother with using condoms.
4. Barebacking is less expensive than having protected intercourse. Using condoms can be expensive, especially if you are on a limited income.
5. If both men are not infected with HIV, nor any other sexually transmitted diseases (STDs), barebacking is 100% safe from infectious diseases. In this case, barebacking falls under the category of "safe sex."
6. Barebacking can sometimes promote monogamy. If two men are monogamous and uninfected, the ability to safely bareback gives them an incentive to stay monogamous with one another. Barebacking also strengthens the emotional ties between a gay couple.

The Drawbacks of Barebacking:

1. If you bareback with a person who is infected with HIV or another STD (even if they do not have any noticeable symptoms), you can become infected and get sick from these diseases. Getting sick from HIV/AIDS and other STDs is not a pleasant experience!
2. If you bareback with a person who is infected with HIV or another potentially fatal STD (such as hepatitis B), you can die from these diseases.
3. If you are infected with HIV or another STD, and you bareback, you can infect other people (including those you care the most about, such as your lover and your friends).

Why do gay men bareback, despite the possible risks? There are many reasons for this, including:

1. Some men no longer fear HIV/AIDS. Some men think that if you just take a few pills everyday (i.e., taking HIV medications), HIV/AIDS is not a problem, it is fully manageable, and it is easy to live with. But talk to many people who have HIV/AIDS and they will tell you a very different story!
2. Some men live only for today, and don't think about the future. Some men think that they need to do everything they can in their life now, since they don't expect to live very long.
3. Some men are dealing with low self-esteem issues. They don't think that their health, or their life, is worth protecting. Low self-esteem is common in the gay community, and is often related to the way that society treats gay men.
4. For some men, they believe that "if it feels good, do it." Some men are willing to take their chances, and the consequences.
5. Some men who are already HIV positive think that they no longer need to use condoms, and are unaware of the health consequences of HIV reinfection and the risks of other STDs.
6. Some men are in denial that they will ever get infected with HIV or any other STD.
7. Some men simply enjoy barebacking better, and think that barebacking is worth the risk. Some men prefer the "skin-to-skin contact," regardless of the risk.
8. Some men simply hate using condoms. Men complain about condoms giving them less sensation, and they also complain that they are more likely to lose their erections while using condoms. Some men also find putting on condoms to be a hassle. A common complaint is that condoms interfere with sex play.
9. Some men hear that "everyone else" is barebacking these days, so they are willing to do it too.
10. When someone is drunk or high on drugs or alcohol, he is more likely to bareback. The overall rates of drug and alcohol use (and abuse) are high in the gay community.
11. Some men are totally unaware of the risks of STDs other than HIV. Although a lot of effort had previously been taken to educate gay men about HIV, almost no effort has been made to educate gay men about other STDs. Besides HIV, other STDs that can be transmitted through barebacking include gonorrhea, hepatitis B, hepatitis C, genital/anal warts, herpes, syphilis and others. Some of these STDs are incurable (like herpes and genital/anal warts), and some are potentially fatal (like hepatitis B and hepatitis C).
12. Some men are so sick of hearing about HIV/AIDS, that they just ignore the whole issue.
13. For some men, if their partner does not bring up the subject of HIV or other STDs, they will just assume that their partner is not infected, and that barebacking would be safe. Some men think that, "if he were positive, he would tell me." This is a dangerous assumption to make, since some men with HIV, or other STDs, will not tell their partner ahead of time that they are infected. This is often due to the fear of rejection, embarrassment, denial, and other reasons.
14. Some men are more likely to bareback with their lovers, or other guys they personally know. Barebacking is used as a way to show intimacy, sharing, and caring between men. The exchange of semen is seen as a way to emotionally bind two men together. Condoms are sometimes seen as a barrier to intimacy.
15. If a man is not worried about getting HIV, chances are very good he isn't worried about getting other STDs either.
16. Some men get completely caught up in the "heat of the moment" and end up having unprotected sex, even though they weren't planning to bareback. Sometimes when a man gets in the mood, his sexual desires overtake his rational thinking.
17. Some men will bareback as long as they are the top partner. There is a common myth that only the bottom partner can get infected during anal intercourse, and that it's safe to bareback as the top partner. This is not true. In reality, when having intercourse with a person who has HIV or another STD, the top partner is at high risk, and the bottom partner is at even higher risk. Note that neither partner is at low risk of infection.
18. In young gay men specifically, they have not experienced the loss, devastation, and death of their lovers and friends (caused by AIDS), that many older gay men have endured. Therefore, younger gay men are less scared of HIV/AIDS, and therefore, are less likely to protect themselves from HIV infection.
19. Even among older gay men, safer sex rates are starting to decrease, and barebacking is on the increase. This is because, realistically, it's difficult for men to use condoms every time they have sex with every partner over a prolonged period of time (months, years, or even a lifetime). Telling a man to use condoms with every single partner, every single time he has sex, for the rest of his life, is a major challenge (and for some men, a very unrealistic goal). Unless there is ongoing education and intervention, it is not surprising if men use condoms less and less as time goes on.
20. It has been suggested that barebacking is a form of rebellion. Gay men hear over and over that they "have to" use condoms. For some men, barebacking is their way of rebelling against "the establishment" telling them what they can, and cannot do.
21. A guy may bareback if his partner tells him that he has tested negative for HIV. But this does notnecessarily mean that barebacking is safe. First of all, since it takes an average of three months for an HIV test to accurately show if someone's HIV positive (and it can take up to six months for some people), a negative test does not always mean that a person is not infected (if they got tested before three months). Also, if a guy who has tested HIV negative has put himself at risk again (even one time), his negative test result would no longer be valid, and he would need to be tested all over again. In addition, some men who have not been tested for HIV recently (or who have never been tested for HIV at all) will tell other men that they tested negative, as a way to get other guys to bareback with them (in other words, as a "pick-up line"). Finally, even if a guy is not infected with HIV, he may still be infected with other STDs. Barebacking would only be safe if a man tests negative for both HIV and other STDs, three months and, just to be sure, at six months or more after his last possible exposure to these diseases.
22. There are even a small number of men who are purposely going out to get themselves infected with HIV. These men are known as "bug chasers"

Although much less common, there are some HIV-negative men who willingly bareback with other men who they know are HIV positive (even when they know the risks). There are many reasons for this including:

1. Some men like to "live life on the edge," and get pleasure out of taking their chances. You can say that these men are "sexual daredevils."
2. If a guy's boyfriend is HIV positive, he is sometimes willing to bareback with his boyfriend as a way of demonstrating his love, even though he knows that he can become infected himself.
3. Some men do not mind getting infected, as long as they get infected only from their boyfriend. They see HIV as a special way to further bond their relationship with their lover.
4. HIV-positive men often have their own social circles and friendships. Some men allow themselves to get infected in order to get into these social circles. Being HIV positive can give some men a "sense of belonging." Some HIV-negative men have also commented that "people with HIV get all the attention, so why am I missing out?"
5. Being positive sometimes brings with it an increase in social services and benefits (housing, food, public assistance, etc.). A person who is HIV positive sometimes qualifies for more social services than someone who is not infected.
6. Some men simply do not care whether they get infected or not.
7. Some men think that if they get infected, they will no longer need to use condoms (not knowing about the problems associated with HIV reinfection, or other STDs).
8. Some gay men are fatalistic. Some of them think that getting HIV is inevitable, so they do not try to avoid it. Some men feel that trying to stay HIV negative is too stressful, and ultimately allow themselves to get infected in order to "just get it over with." There are even some men who think that AIDS is "just part of being gay."

There are several slang terms you may sometimes hear related to barebacking:

Barebacking parties = group sex parties where condoms are not allowed to be used. There are different types of barebacking parties:

1. all positive barebacking parties (where everyone at the party is HIV positive)
2. all negative barebacking parties (where everyone is supposedly HIV negative)
3. Conversion parties 
4. Russian Roulette parties

1. Bug chasers = men looking to get themselves infected with HIV.
2. Gift givers = men with HIV who are willing to infect bug chasers.
3. The gift = HIV
4. Conversion parties = group sex parties where bug chasers allow themselves to get infected by gift givers.
5. Russian Roulette parties = barebacking parties with both positive and negative men. Negative men take their chances that they will be infected when having sex with the positive men there. Depending on the circumstances, the participants may or may not know ahead of time who is positive and who is negative.
6. Bug brothers = a group of positive men.
7. Charged cum or poz cum = semen from an HIV-positive man.
8. Fuck of death = intercourse where HIV infection takes place.

Source: From Rick Sowadsky, M.S.P.H.

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