4 May 2010

Thoughts on why gay men bareback

Can we talk about "barebacking"? You know, unprotected anal sex between men. Sex without a condom. "Raw" sex. Or, if you prefer the almost comically clinical language of early safer sex education, sex during which "bodily fluids" may be "exchanged."

"The lonely I ecstatically dissolving into the we ... It's the common
denominator of every form of bliss -- romantic, sexual, political,
religious, mystical. Everyone wants and welcomes this blissful merger."
- Irvin D. Yalom, Love's Executioner 

We all know how risky barebacking is, and we all know it goes on all the time. You might think that by now, thirty years into this horrible epidemic, barebacking would be a thing of the past. But it isn't. Far from disappearing, I'd bet that despite valiant efforts at HIV prevention, barebacking is on the rise. If I'm right about that, then we have to put aside any discomfort the topic may cause and try to understand why guys bareback.

A few clarifications before we start. First, I know gay men aren't the only ones who bareback. Straight people bareback all the time, of course, but unlike us, they don't make up titillating names for it. They just call it "having sex." Second, I don't want anyone to think I'm here to pass some kind of moral judgment on barebacking because, frankly, I'm in no position to do so. Finally, let me clarify what I'm not talking about here. I'm not talking about guys who bareback because they believe, rightly or wrongly, that they are not putting themselves at risk for HIV in a given sexual encounter. I'm speaking only about men who voluntarily assume the risk of transmission by barebacking.

With those preliminaries out of the way, I thought I'd look at a few of the possible explanations for why gay men might choose to bareback, even when they know the risks. I'd then like to offer my own view of what motivates barebacking. That's a lot of ground to cover, so I apologize in advance for the length of this post.

Let's start with the most obvious explanation for barebacking. Sex without a condom just feels better. Anyone who's ever fucked (or been fucked) without a condom knows just how much sensation is lost when you suit up. This loss of sensation can do more than just diminish sexual pleasure. Many guys can't reach orgasm if they're wearing a condom. Worse yet, many can't stay hard wearing one, so using protection may create or feed performance anxiety.

Another explanation I've heard is that gay men bareback out of a need for transgression, from a desire to flout societal norms and rules. Historically, gay men were seen as sexual outlaws, and part of our identity revolved around our outsider status, a status that even conferred a certain "cool." Today, with gay marriage making its halting march to legality and gay couples adopting children, being gay may seem kind of ordinary, and some men may need to find ways to hang on to our old outlaw status. (This might explain, for example, why some gay men continue to seek out sex in parks and restrooms, even though such furtive public coupling is no longer necessary when the Internet offers us sites like adam4adam and dudesnude.) And if transgression is what guys are after, what could be more transgressive than violating the first commandment of safer sex education by refusing to use a condom?

Maybe gay men bareback out of a sense of fatalism or exhaustion. Perhaps they feel it's more or less inevitable they'll eventually become infected, so they might as well just get it over with. Some men may find the effort of trying to stay HIV-negative too stressful. They may bareback so that they can stop worrying about the possibility of contracting HIV. These men may experience seroconversion as a kind of relief. Others may simply be suffering from "condom fatigue" after decades of having to practice safer sex.

I don't doubt the validity of these explanations, but I think the answer must lie deeper within the psyche. The emotional need that drives men to bareback must be so powerful that they will literally risk their lives to satisfy it. If you ask me, barebacking is an attempt to escape from the awful sense of isolation that we all experience as human beings. That isolation is perhaps an inevitable consequence of our separate existence as individuals. But it's particularly acute for us gay men, who have grown up in a society hostile to our identity. Having spent so much of our lives on the outside, alienated from members of the majority (straight) culture, we gay men have an intense need to feel truly connected to others like ourselves.

To me, the urge that I think motivates barebacking is perfectly understandable. It is, after all, just a deeply felt desire for the most profound form of intimacy, a desire that goes beyond merely wanting to be close to someone else and crosses over into a need for union -- for the "blissful merger" that Irvin Yalom describes. Barebacking can be seen as the ultimate attempt to remove all barriers between ourselves and our partners, to literally become one. It's an effort to escape the loneliness that haunts our separate existences, and to be freed, if only momentarily, from the solitary confinement of our individuality. Men who bareback may be seeking what James I. Martin calls "transcendent sexual experiences." (Martin, 9 Sexualities 214-235 (2006).) That is, sexual experience in which they feel a dissolution of their separate selves and a fusion with the object of their desire.

If what barebackers are looking for is merger, then it's easier to see why they wouldn't want to use a condom. In the search for merger, a condom is not only a physical barrier but an emotional and psychological one. Just as it prevents transmission of pathogens, it also stands in the way of what we all crave -- that sense of union. Using a condom conveys a message of rejection and mistrust. It tells our partners that we are not willing to share ourselves completely. The failure to use a condom is obviously problematic, but that is because of the existence of HIV, not because of the existence of the desire for transcendence and merger. Perhaps rather than seeing the desire itself as a problem, we should understand it as normal. If we were to do so, perhaps we could explore ways to fulfill this desire that don't involve risky sex. 

I don't know whether learning the motivations of men who choose to bareback will help us design better HIV prevention programs. I am fairly sure, though, that if we don't identify what makes men have unprotected sex and at least try to understand and address their underlying emotional needs, we are unlikely to develop effective strategies for curbing the practice. And I am firmly convinced that no understanding is possible so long as we refuse to discuss the topic openly. I'd therefore urge us to listen without judgment to men who bareback. Let's hear their reasons for engaging in unprotected anal sex. Then let's see if we can't acknowledge their needs as legitimate and help them find ways of satisfying them without barebacking. 

The language of the discussion I propose will have to be brutally frank, open, and I dare say, raw. This is an instance in which nothing less than complete honesty will do. But for those of us concerned with stopping the spread of HIV, this is a discussion we need to have, and have soon. 

(Acknowledgement: I am indebted to UCSF researcher Alberto Curotto for sharing with me a wealth of background material for this post and for giving an amateur the benefit of his professional experience in the field of behavioral research.)

The article was first published on TheBody.com and is republished with permission from the author, John who writes a HIV/AIDS blog on the website. He is 49 years old, a lawyer by profession and was diagnosed as HIV positive in 2004. He lives in San Francisco, California.

We invite readers to share why you engage in unprotected anal sex (if you do).