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How many guys bareback? - HIV Digest - unprotected sex survey - Brief Article
Men's Fitness, July, 2002
Scientists at the Centers for Disease Control and Prevention are trying to gauge the statistical impact of "barebacking," which involves potentially dangerous unprotected anal sex. In a CDC survey of 554 gay or bisexual men in the San Francisco Bay area, about one in 10 said they had recently barebacked.
The investigators define the term closely, reserving it only for the pursuit of anal sex without a condom between "non-primary" partners, which excludes "the context of negotiated safety." True barebackers must also be familiar with the concept; this distinguishes the act from poor planning or spontaneous decisions during sex.
Of the 70 percent of the subjects who understood the term, 14 percent--22 percent of the HIV-positive men and 10 percent of the HIV-negative men--acknowledged that they had barebacked one or more times in the past two years. The median number of bareback partners in the previous 12 months was three. Although barebacking is ostensibly life-threatening only to those who are uninfected, HIV-positive practitioners are at risk for contracting drug-resistant "super strains" of the virus.
"The reason most frequently cited for barebacking"--by four out of five men--"was to experience greater physical stimulation," notes lead author Gordon Mansergh, Ph.D. "Feeling emotionally connected with a partner was also a relatively common reason. A condom is a physical barrier, and it represents for some people an emotional barrier as well."
The proportion of those who barebacked did not vary significantly when measured by race, ethnicity, education, income or sexual orientation. While there was a serostatus-associative trend (positives with positives, negatives with negatives), many men who barebacked reported unprotected receptive and insertive anal sex with men of different or unknown HIV serostatus during their most recent bareback encounter. Drugs and alcohol were a notable cofactor: 58 percent of the subjects reported being intoxicated during their last unprotected incident.
Along with psychological issues such as anger and low self-esteem, medical misperceptions also tend to inform barebacking decisions. Some of the subjects considered AIDS to be a chronic, treatable disease and thought that HIV drags defuse the danger of viral transmission.
Highly active antiretroviral therapy has extended the lives of many people with HIV, but the regimen has been in existence for only five or six years and its long-term efficacy is unknown. For some patients, HAART has harsh side effects; for others, there are no benefits at all. And though drugs that reduce viral load decrease the risk of transmission, they do not eliminate it.
While the intent of the study, published in the journal AIDS, is to define the size of the barebacking subgroup, adding figures for spontaneous unprotected anal sex more than doubles the population at potential risk. "If we look at those rates overall in the same sample, they're much higher," says Mansergh. "It's 30 percent or so within just the previous three months." Social stigma may also keep some respondents from being honest.
"Behavior may differ by whether individuals are primarily putting themselves or others at risk," concludes Mansergh. "New prevention approaches should simultaneously address specific risk behaviors, perceptions of HIV disease in an era of largely successful drug therapy, and issues of treatment resistance, side effects and failure."
CONDOM COMEBACKS
What to say when your partner doesn't want to use protection
The excuse: "You only live once."
The response: "That's what I was going to say."
COPYRIGHT 2002 Weider Publications
COPYRIGHT 2002 Gale Group
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