Author’s Note: The following is a frank, explicit discussion of unprotected anal sex, or bareback sex. To discuss why some people consciously choose to engage in this risk behavior means to discuss the phenomenon’s pros as well as its cons; this should not be confused with glamorizing risk-taking. Your health– in fact, your life– is at stake. Although there are still many things that are unknown about AIDS, it is a fact that there is neither a cure nor a vaccine against AIDS. Condoms are still the best means of prevention, so use them.]
It’s been a decade and a half since safe-sex campaigns first targeted the gay male community with their message that condoms save lives. So why do some informed, intelligent gay men choose not to use them?
Despite the many prevention/awareness campaigns – ranging from death threats (“I like sex as much as the next guy, but I’m not willing to die for it”) to titillation (“Safe sex is hot sex”) – unprotected anal sex never disappeared during this epidemic. Risky behaviors are evidenced by thousands of new infections each year.
Why would some men risk their health or lives for unprotected sex? The most common explanation is the protease inhibitor, a relatively new class of drug that has made remarkable progress in treating many people with AIDS. The drug has been very successful in reducing the symptoms and even the viral load counts of many PWAs. These drugs would appear to some as a safety net: gay men still don’t want the disease, but they believe that if they get it, they’ll be able to keep it under control. Protease inhibitors have transformed the deadly disease in the minds of many HIV-negative gay men into something “manageable” or “a minor nuisance.”
Bareback sex, also called raw or skin-to-skin, essentially refers to intentionally seeking out anal sex without a condom. The act sex is nothing new, but the idiom is.
“The popularization of that term seems to indicate a shift from describing unprotected sex as unsafe sex, to describing it as sexy and alluring, which the term barebacking implies. That is certainly relatively new,” said Gabriel Rotello, author of Sexual Ecology: AIDS and the Destiny of Gay Men.
Several studies across the globe in the last year indicate an increase in willingness by men surveyed to engage in unsafe sex because of the advent of protease inhibitors. Does this mean “barebacking” is becoming epidemic? Not necessarily. Most studies do not examine whether the cases of unsafe sex were “slip ups” or within the context of a relationship. Most activists will agree that there’s a difference between unprotected sex and unsafe sex. Couples who share the same HIV status and are in committed relationships may choose to engage in unprotected intercourse. Within AIDS prevention circles, this is generally referred to as “negotiated safety” and not bareback sex. Couples whose relationships follow “negotiated safety” rules may have sex with other persons, but maintain safer sex guidelines (using condoms) with outside partners.
For AIDS prevention, protease inhibitors have been bad news. For gay men who were watching their friends suffering and dying of AIDS, and who then witnessed their friends recovering from AIDS-related illnesses, the new drugs made the risk of HIV infection “no longer as dire as they once were,” Rotello said. “It is difficult to argue that many people with AIDS are doing much better than before.”
And for people for whom safe sex was always a tremendous struggle, for those who were not uniformly safe in the past (a number which figured roughly 50 percent even before protease inhibitors), Rotello said, “this news would tend to be a powerful thing to allow them under certain circumstances to engage in unprotected sex.”
Unfortunately assumptions about the efficacy of protease inhibitors are incorrect. Not everybody can either afford or benefit from protease inhibitors, the drugs don’t last forever, and they often have harsh side effects. Furthermore, persons who are already infected with HIV, believe they have “nothing to lose” and engage in bareback run the risk of re-infection with a drug resistant type of HIV. There is also a possibility that multi-drug resistant strains of HIV are developing.
Michelangelo Signorile, who brought the subject to some prominence last summer with his column in Out magazine, attributes the increase of instances of bareback sex to “a combination of a bunch of things. Protease inhibitors were just the icing on the cake. I think it’s a lot of reasons. One main reason for younger people is they think they can’t get it. It’s so much not a reality to them; it seems remote. They think of it as something for the older guys. Or they think it’s for people who are really promiscuous, nobody that they know, not their friends.
“I think for some people it’s a fatalistic live-and-let-live attitude,” he continued. These people, he said, “might have a realistic idea that they are already infected and say, ‘I don’t care. I just want a great time.’ It’s also in some circles the influence of drugs and alcohol. The circuit is growing bigger and bigger. For some men, it’s something they might not do if they’re not on drugs.”
Signorile believes that the bareback sex phenomenon “feeds on itself and grows. Once you have some people promoting barebacking and making it a hip thing, it makes it harder for a lot of men not to do it.”
He said he has encountered both HIV-negative and HIV-positive men who, in a circle of men with the same serostatus, were made to feel “like a dweeb or nerd” because they wanted to use a condom. And, he said, unless bareback sex is talked about “in a way that’s really negative, it becomes compelling for some people.”
Richard Elovich, director of HIV prevention for the Gay Men’s Health Crisis, believes that one of the problems with current prevention efforts is the dilemma of HIV-negative men who want to affirm remaining HIV-negative without further stigmatizing people with AIDS. Safe se messages tend to use the “condom code” that says we are all equal, but these don’t address the negative things about living with a life-threatening illness.
In an open letter to the gay community, Elovich writes, “”…Prevention isn’t just about safer sex and condoms; it’s about saying, ‘I’m uninfected and I don’t want to get infected,’ or ‘I am infected and I don’t want to infect someone else.’ …As crucial as having a condom in your pocket is the acknowledgment that the sex you are having is a powerful and important experience for you, and that you are conscious that you risk getting infected or infecting someone else.
“Fucking and getting fucked are powerful and important experiences for many of us… Let’s talk about that. About how each of us looks and feels as a man getting fucked, about how a relationship changes when we get fucked or about how I might want to give somebody my ass but not my life. Conversations about this are so important because they can’t be done anymore with a slogan.”
Elovitch believes that we need to “move beyond latex education to the real, messy complexities of sex education… Sex, safer or not, happens with someone else whether that relationship lasts 10 minutes, two years or a lifetime. And while some of us may identify with a role or one particular sex practice, the reality is that most of us change what we do depending on who we’re with. And what we do or don’t do changes the relationship…
“Talking about these experiences helps us to become conscious of them, as unerotic as that may be… If this were the ’70s we’d probably call this kind of thing consciousness raising… What we need are consciousness-raising groups that electrify us and force us to sit up and think about what we’re hearing others say or hearing ourselves say out loud,” Elovitch writes.
Although HIV-negative men may be reluctant to speak negatively about becoming HIV-positive, its trendy to have open discussions about the positives about living with AIDS.
In Riding Bareback, HIV-positive Poz columnist Stephen Gendin describes being fucked without a condom: “When he came inside me, I was in heaven, just overjoyed… Knowing the guy was positive made it empowering, not guilt-inspiring. I relaxed into my desires instead of fighting them and felt good doing so… I can’t comment on a negative guy’s decision to go raw, but for us positive men, the benefits are obvious. The physical sensation is much better. The connection feels closer and more intimate. The sharing of cum on the physical level heightens the sense of sharing on the emotional and spiritual planes… There’s even something empowering about the idea of sharing someone else’s HIV. It’s like being thrown into jail for life and then, while serving your time, having the warden threaten to extend your sentence. The threat has no power because nothing can make a life sentence any worse.”
Acknowledging that he is “already resistant to all approved nucleoside analogs and protease inhibitors, I worry a little about being re-infected with a more dangerous virus. I understand that I do present a threat to most positive guys I might fuck raw with,” Gendin acknowledges, then concludes that “part of the joy of sex is its obsessive, all-encompassing irrationality, but condoms have prevented me from exploring that side. Riding bareback with other positive men is a less guilt-ridden way to indulge in that exploration.”
In a controversial speech delivered at the Creating Change Conference, Sex Panic activist Tony Valenzuela spoke to a crowd of more than 150 people on the topics “of sexual liberation, sexual self-determination and sexual repression… [and his] personal journey of being HIV positive, my sex politics and lifestyle.”
In an essay published on Sex Panic! NYC’s website, Valenzuela recounts his speech: “The levels of erotic charge and intimacy I feel when a man cums inside me is transformational, especially in a climate which so completely disregards its importance.” He told his audience “about how beautiful and intimate and powerful that sex was for me – how empowering it felt not to fear another man’s semen.”
Although he does not advocate bareback sex, Valenzuela states “it is patently false and irresponsible to state that there are no situations in which unprotected sex for gay men is healthy, either physically or emotionally… there are times in which unprotected sex is safe and sound. Many gay men do, in fact, on their own, forgo condom use by creating personalized guidelines that specify the situations in which they feel comfortable barebacking (i.e. both men HIV negative, both men HIV positive, etc.)…. I also made very personal and qualified statements about my decision, as an HIV positive man, to have unprotected sex, a decision which does not always prioritize physical health over erotic, psychological or emotional needs.”
Attacked by some for affirming the right of HIV-positive men to ever engage in sex without condoms, Valenzuela writes in his essay that he does not regret his speech. “Intercourse without protection is not disposable; it does have unique value, and provides a forceful intimacy and eroticism unmatched by sex with condoms, maybe not for all, but indubitably for many gay men. This needs to be said and respected, because if not, we are lying to ourselves…”
In an article entitled “Protease Dis-Inhibitors?” Nicholas Sheon and Aaron Plant note that “AIDS prevention efforts inevitably tend to silence discussions of anal sex as an act of sexual intimacy and pleasure. When risky behavior is discussed, it is often framed in terms of pathology (“relapsed”), sin (“slipping up”) or even murder. The barebacking phenomenon can be seen as a reaction to prevention efforts which have failed to adequately address the complex meanings of sexual behavior in relation to the divergent identities that have developed around HIV serostatus.”
In Michelangelo Signorile’s July 1997 column, Bareback and Reckless, the writer interviewed a 27-year-old man whose American Online profile describes him as a bottom into bareback sex. Signorile said he was “one of more than 250 users who have the word bareback in their America Online profiles.” He also noted that “bareback sex parties are now quite common, where negative may mix with the positive.”
Six months later, Signorile said he believes the bareback phenomenon “has increased even more. And I touched on that in Life Outside [Life Outside: The Signorile Report on Gay Men: sex, Drugs, Muscles and the Passages of Life, HarperCollins]. When I was finishing the book, say December ’96, the word was just beginning to be used. I wanted to have something on it; I had an idea we’d be seeing more of it. I think now it is even bigger.”
Signorile said he was in Chicago recently and some young men there informed him that they really have to fight to have safe sex. For those around them, barebacking has become the norm and safe sex the exception to the rule. “They said, ‘We have to make a point of using condoms.'”
One of the young men from Chicago told Signorile that he encountered so much annoyance and rejection over not engaging in unprotected sex that he gave up anal sex completely, “because it’s too much to navigate.”
There is still another theory, beyond self-loathing and new medications, that explains the appeal to some for unprotected sex. Some queer academics believe barebacking is just an extension of the sexual liberation movement.
“Gay men have traditionally been at the vanguard of sexual liberation and experimentation with new forms of human relationships. This experimentation has always existed under the threat of sanction from powerful institutions such as the police, the church, schools and the family. Barebacking can thus be seen as merely the latest in a long line of challenges by gay men to the sexual status quo and the institutions which support it,” Sheon and Plant write. “Attempts to ‘manage desire,’ whether they originate from within or without the gay community, tend to produce ‘transgressive desire,’ a fetishizing of certain acts because they are dangerous, stigmatized and emotionally charged. Thus the barebacking backlash appears to be particularly aimed at subverting AIDS prevention messages by fetishizing not just sex without condoms, but the very ‘exchanges’ of fluids that have been prohibited between gay men.”
And this is perhaps the most alarming aspect of bareback sex. Whereas some men “slip” and others choose to forgo condoms because of their love of a partner, some men now speak openly about desiring to either infect others or become infected.
Michael, 36, is the webmaster of Xtreme Sex. The Dallas-based software engineer designed the site for HIV-positive men looking to for sex nearly two years ago and continues to maintain it. The site, located at http://rampages.onramp.net/~tmike/xtremesex, has already logged over 120,030 hits and has over 300 regular visitors.
“I never intended it to be a place for counseling or therapy or, necessarily, information. It’s primarily to be a place where there are certain givens. People are not going to run when they find out you’re HIV positive. That is a fairly stressful thing for people who try to hook up online or, hell, in person,” he says.
Michael, who goes by the screen name PigBotm, said he got the idea for the site when he was on AOL. His profile, he admits, “was horrifically nasty. I got a message from some guy and we started talking. He and a couple friends of his that he talked with on AOL, one of their big fantasy issues was not HIV infection, per se, but just the risk concept in general. And because some of these people were HIV positive, it was a handy risk to attach to. I thought this was too interesting not to have on the web page.”
Within a couple weeks of speaking with this core group, Michael had set up the initial version of Xtreme Sex. Soon, he said, “it became obvious that this group was larger than I thought. Even I was surprised. It struck me so strongly. The idea [of risking infection] had never even crossed my mind. And I thought I was a tramp… I thought I’d seen and done everything.”
The site eroticizes HIV and unprotected sex among HIV-positive men. It would seemingly encourage both HIV-positive and HIV-negative men to engage in unprotected sex with positive men. The site refers to HIV/AIDS as “the gift” and to “Pozcum” as “the Fuck of Death.” In a bizarre twist, a small number of HIV-negative people on the site would seem to seek HIV infection. One personal introduction reads, “I’ve tested negative six times. Guess I haven’t found the right virulent strain… yet.”
Michael believes he’s been HIV-positive for about 13 years and says, “I never had a risk fantasy. That was never a big deal to me, still isn’t. I certainly understand and appreciate the risk in general, and I do things that are risky. But that doesn’t appeal to me.”
Michael and Xtreme Sex has come under a lot of fire for what is perceived as glamorizing and eroticizing infection, and possibly encouraging HIV-negative men to purposely become infected.
“I’m very much of the opinion that everybody gets to do what they want to do. I don’t believe in anarchy, but if the people affected are consenting adults and mixed serostatus, it’s not my place to say… I try very hard to avoid judgement.
“I do have a problem with a combination of a negative bottom and positive top. That’s the one I would bitch about if I were going to. I have encountered people who have fantasies about that situation as either bottom or top, and people who actually play that way.”
He said he has little tolerance for “people who do it with complete disregard with factual information” about the risks of transmission and the dangers of HIV.
On the other hand, “I don’t get too much on a soap box as long as I believe they’re being [informed]… some people are doing it out of desperation or depression rather than choice. I have run into people who that’s what they seem to be about. People who are pure dysfunction. Those people, I do get on a soap box for them.”
Although he has been quoted out of context as saying that AIDS is “a minor nuisance,” Michael said what he meant was that AIDS’ “day-to-day intrusion on life is not that horrific… But I have much, much first-person knowledge that it is more than an inconvenience.”
He said that he has never intentionally infected someone and would not. “I couldn’t do that any more than I could do anything else that would clearly have overwhelming potential to alter somebody’s life the way it does. There is nothing positive that comes out of being positive,” he said. “Some people are able to use it as a tool to achieve something positive in their lives. Facing one’s own mortality will do that. But it is not, itself, a positive thing.” Michael does acknowledge, however, being “asked to infect someone because of being associated with the page.” Sound unbelievable? Maybe it is.
He said of the people who post infection fantasies, “I know for a fact that many of them are actually HIV positive, but into the fantasy either for themselves or their partners.”
He said that he chats regularly with many of the site’s regular contributors and hangers out, and has learned that “a lot of them were HIV positive in the first place. Some of them I haven’t heard are positive…. but it’s probably a small number who are actually negative if we lined them up and tested them.”
Why would someone want to get infected, to get “the gift?”
To Michael, “it is an extension of the idea that a lot of bottoms have who play in kink. These people have a fundamentally different view of sex, of people, of the way of the world than those who do vanilla. People who play kinky tend to want their brain involved in what they’re doing.
It’s a way to take your mind where you haven’t been before. It’s a common thread with bondage; it’s a head trip. The expression of HIV as a gift is very much like some people feel about being beaten or pissed in or on, or any of those kinds of things. The idea of something from the other person being a gift is nothing new. It’s just a part of the general mind set of people who play kink. They view it as a relationship, not as an activity. So another person’s body fluids are of value to them. The inclusion of HIV there is a matter of necessity. It’s different, it’s special not everybody’s got it.”
And the banner that reads “Pozcum: The Fuck of Death” is also intended to be sexy. “To some of the people who were a part of the core group, it is intrinsically sexy to risk death. That’s why I phrased it so blatantly. Part of the intent, admittedly, of the site is to be as blatant as possible about what we were talking about. I realized a lot of people would be shocked by it, and that’s OK, too.”
Michael said feels some responsibility about what goes on as a result of his web site. “I put the fact and fantasy section up not long after putting the page up, because [many visitors] didn’t have enough information to make the decision [about whether unprotected sex was right for them]. I decided I don’t mind what anybody does, but not out of ignorance. That’s cheating them out of making an informed decision. I think people should be able to easily get enough information to begin to make decisions about what they do in their life. I’m a firm believer in informed consent, that once someone is informed and has to their own satisfaction looked at the possibilities, then they’re on their own.
“I try to enumerate [in that section] all the really obvious dangers and issues about it. I can’t cover them all and I don’t intend to. But at least I put enough information for people to stop and realize that this is not without risk even now, whether we’re talking re-infection or other illnesses.”
So where is all this taking us? Where do we go from here in terms of prevention efforts?
“Whatever progress we’ve made in terms of HIV treatments and the fight for the rights of people with AIDS to live as long and as well as possible, without discrimination or stigma, if we take HIV prevention seriously, the bottom line is a painful one: HIV is undesirable… in all of our lives. That’s difficult to say, because for guys living with the virus, there is a real struggle to keep a tenuous hold on feeling OK about being infected. People with HIV aren’t undesirable, but the virus is. We might as well throw in the towel on HIV prevention unless we can say that living with HIV should not be a normal way of life for the next generation of gay men,” Elovitch writes in his open letter. “And because there’s something implicitly hurtful about that division, we in the gay community feel conflicted about HIV prevention. If I as an HIV negative man draw the distinction, I’m conscious that someone who’s HIV positive is going to feel that I’m saying there’s something wrong with him. The reality is there is something wrong: you have to live a different life because you have a potentially fatal virus…
“What is so seductive about reducing HIV prevention to what is now called the ‘condom code’ is that it papers over some of these painful distinctions: it allows us a way to feel that HIV status doesn’t make a difference; to pretend we are all the same; to act as if having a fatal virus doesn’t even make a difference in our sex lives; that we don’t have to deal with disclosure; and most painful of all, we don’t have to deal with the meanings of the differences between being positive and negative.”
Elovitch believes open discussion about what we do and why we do it may stem the tide. His is a conservative approach.
Like Larry Kramer before him, Rotello believes the future of gay sex must begin with cutting down the number of sexual partners and supporting monogamy within the gay community.
For gay men, many of which grow up feeling isolated and alone, sex with multiple partners has provided a feeling of belonging, closeness and community. But relationships can do that, too, Rotello says.
“For most of the epidemic, people have fought and argued that condoms alone are a sufficient form of safer sex and that if we could simply get people to use condoms every time they had anal sex, then we would be able to prevent most new infections, certainly not all, but most,” Rotello said. Now 15 years into the epidemic, he said it is clear to him that condoms are not the sole answer.
“Even though we have promoted condoms and educated people, and provided condoms in an efficient way, and even though virtually every sexually-active gay person now from their teen years onwards knows how HIV is transmitted and knows that condoms can prevent it, we have still not been able to bring the epidemic down below the tipping point with condoms. And the reason is, not everybody uses condoms every single time they have anal sex.”
His book, Sexual Ecology: AIDS and the Destiny of Gay Men, takes a step beyond condoms in developing a strategy to wipe out AIDS. Rotello said transmission among gay men is based on three factors: infectivity, prevalence and contact rate. The former condition refers to the likelihood of becoming infected with HIV when engaged in sex with someone who is HIV- positive and the second condition refers to the percentage of people within your group of potential sexual partners who are already infected.
It is dealing with the third factor that Rotello is at his most controversial. “The contact rate, the number of people that people have sex with, is something you can do something about, and that’s the thing that we have not addressed so far in safer sex. We have basically said that if you simply argue that everybody should use a condom every time they have sex, it doesn’t matter how many people they have sex with… But if you factor into that the fact that people don’t use condoms every time they have sex, and despite everything we’ve done for 15 years, it looks like they’re not going to, then the contact rate becomes very important,” Rotello told Oasis, an internet resource for gay youth. And so his answer is to cut down the number of sexual partners.
Signorile agrees. “We’re in a culture of unbridled multi-partner anal sex,” he said. And the rate of HIV transmission “just comes down to a law of averages.
“Safer sex and the safer sex message have worked as well as they can. We need to try to lower the contact rate for anal sex. Just by the law of averages, that means less slip ups and less transmission. And that’s where there’s controversy. I think that there are so many people who are smart enough to look at the data and say, yes, this is what needs to be done,” Signorile said.
“I really think it’s a small but very vocal group that’s really being adamant, saying ‘no, this can’t be true.’ I’ve also found a number of people saying, ‘you’re probably right, but this is where I’m comfortable. I’m comfortable with this rate.’ At least they’re being honest. It’s like, we know if we lowered the speed limit, we’d have less deaths and if we raised the speed limit, there’d be more deaths. We’re comfortable with this number of deaths. But I’m not comfortable that each generation will be 50 percent infected. I think most of the community wouldn’t be comfortable with that.”
Signorile said that seroprevalence in most cities is 30-50 percent. “In the older generation, the first generation, upwards of half were infected. What we’re seeing in the next generation, the average 18 year old has a 50 percent chance of being infected by the time he’s 35. There’s a two to four percent infection rate per year. If that continues, you’re talking 50 percent within 10-15 years.
“We really do have to think of other things… Protease inhibitors are a treatment, nothing near a cure. They’re already showing that they’re limited, not working now for a lot of people that they once used to work. And if a drug resistant strain starts to navigate through the community, you’re gonna have a whole new group of people for whom these drugs aren’t going to work shortly after they’re infected. These drugs will mean nothing for a whole generation, unless new drugs comes out.”
For many members of the community who stand steadfast in their belief that any position calling for less partners is anti-sex and thus anti-gay, Signorile, Rotello and their followers are the enemy. But they will not be swayed.
“The level of support that you get for promoting a holistic approach far, far exceeds the level of attack,” Rotello said. “The attacks tend to be loud, vociferous and nasty, and the support tends to be quiet and calm. For every time I’ve been attacked about AIDS and AIDS prevention, there’s ten, 15, 20 letters of support from within the gay community.”
Among Signorile’s and Rotello’s most visible critics are members of Sex Panic. A leaflet handed out at New York Pride events last June criticized the community’s most visible “spokemen,” who they claimed “have bad answers for real questions. They say we caused AIDS; they blame us for spreading it; they tell us to get married. Andrew Sullivan, Michelangelo Signorile, Larry Kramer, and Gabriel Rotello talk all the time. But look at what they are saying: they don’t like gay culture, they don’t believe in safer sex, they don’t trust you. They reduce lesbians to sexless homebodies and want gay men to be the same. Are shame, enforced monogamy and small town values what you want?”
Sex Panic has, as much as Signorile and Rotello, politicized sex. And with all politics, there are ramifications.
“This is something we have to face,” Signorile concluded. “What is Congress and what are the conservative elements within the political parties going to start saying, and how are we going to get treated, when it becomes clear that whole new generations of gay men are being infected when we know all about safer sex? When we have epidemiologists talking about contact rate, etc. People are going to question whether they want to put money into that disease. I don’t personally think we should stop putting money towards AIDS. It’s like cigarettes. We know they cause cancer, but we don’t stop putting money into cancer research. But I think it’s something we have to think about. We really put our heads in the sand about it. A lot of gay groups just don’t want to deal with it. We must.”
By M. Scott Mallinger