In his 1997 book Sexual Ecology, Gabriel Rotello specifically discusses gay men’s sexual culture and barebacking from a systems or ecological perspective. Rotello posits that the problem with barebacking is not only that gay men who bareback fail to act individually in their own interests, but also that they fail to act collectively in the interests of gay men as a group. What Rotello is saying is that in addition to a specific act of sex without a condom potentially spreading HIV to a previously uninfected person, each act of condomless sex also helps break down community norms supporting condom use.
The usefulness of using an ecological or systems lens to approach questions about barebacking is supported by research. Studies both in the United States (Joseph et al., 1987) and in Norway (Prieur, 1990) demonstrate that having “social resources” is one of the most influential factors in practicing safer sex for gay or bisexual men who already are well informed of the risk of semen exchange and the dangers of unprotected anal sex. These social resources include accepting one’s sexual identity and leading a stable life with friends. Another way of putting this is that creating one’s own family, and including other gay people in it, is an essential part of having the emotional and social resources necessary to buttress one during times of adversity. This “created family” or “family of choice” may or may not include being part of a committed partnership with one or more people bound together romantically. For gay men without close emotional ties to other people, an active sex life may be the only means of experiencing closeness to others (Prieur,
1990). Therefore, one goal of gay-affirmative therapy is to help encourage gay men to create or strengthen their ties to a community of men. Many gay men who bareback report that it is precisely their desire to feel more connected to a community and foster a sense of community that leads them to take sexual risks.
Thinking ecologically is useful for keeping in mind how the issues of mourning and melancholia have come together for individual gay men and for the broader gay community for approximately the past 20 years. How these factors converge with the natural desire for unrestrained sex that has been a central aspect of gay men’s culture and community is important when thinking about the rise in barebacking. Patrick Moore’s book Beyond Shame (2004) offers extensive discussion of why helping men work through their shame is essential to enhancing their self-esteem and changing community norms, which of course is an ecological approach to preventing new cases of AIDS.
I agree with Crimp when he says that we should not minimize the centrality of freely being able to express one’s sexual desires and that the strains of not being able to do so takes a profound toll on both individual and communal psyches. I have come to believe that for many who engage in it, barebacking is an understandable reaction to the decades
of sadness and mourning, as well as an attempt to create a life-affirming act in an attempt to repudiate shame, the invasiveness of too many deaths, and additional AIDS-related losses. It might be fair to view barebacking as an overcompensation against the horrors and inhibitions imposed by AIDS. For some gay men, barebacking is symptomatic of a compulsive sexuality that they are unable to control. Others find that barebacking is an attempt to recreate the kind of social network that was created out of connecting sexually with other gay men. It is essential to remember that all gay men living under the cloud of AIDS are also members of an oppressed minority with the ever-present specter of homophobia.
Yet a study of 460 gay men in Australia showed that gay men, regardless of HIV status, who had chronic, low-grade symptoms of depression without a current major depression were significantly more likely to report unprotected sex with a casual partner than were men without any symptoms of depression or men who had a major depression (Rogers et al., 2003). The authors comment, “It is not difficult to understand that gay men who have been stigmatized for much of their lives, and who have lived though the devastation of their community by HIV, may sometimes find themselves in a psychological state where they just don’t care about protecting themselves or others.” They add that “dysthymic disorder may be the diagnostic representation of such a mental state and since the condition is potentially treatable, it warrants careful consideration in the prevention of HIV at individual and population levels” (Rogers et al., 2003). The combination of systemic and internalized homophobia and surviving in the age of AIDS creates
a powerful nexus that results in many gay men engaging in behaviors that are symptomatic of an attempt to ameliorate their pain and distress. These behaviors include rates of substance abuse higher than the general population (Morales & Graves, 1983; Stall & Wiley, 1988; McKirnan & Peterson, 1989; Cabaj, 1992), isolation, difficulty in achieving and
sustaining intimacy, and for some, barebacking.
Ron Stall is a leading AIDS researcher who was formerly the director of the CDC’s Prevention Research Branch at the National Center for HIV, STD, and TB Prevention. Speaking about gay men taking sexual risks, Stall identified four significant epidemics co-occurring in the gay men’s communities, which are all interacting, making one another worse, and which influence gay men’s willingness to take sexual risks. These are depression, partner violence, substance abuse, and HIV. Stall refers to this phenomenon as “syndemics,” a syndrome of interacting epidemics. Speaking of the nearly three thousand men in one study, he said: “The higher the number of the epidemics that any particular man experienced, the more likely he was to have risky sex and to test positive for HIV” (quoted in Specter, 2005).
As Patrick Moore (2004) reminds us, sexual liberation did not cause the AIDS epidemic but may be the only way to stop it because the only way to fight shame is to return to an earlier vision of sex as liberation and joy. In response to Moore’s vision, Bronski feels that “it is imperative to remember that this is not a sentimental project of memorializing how good the old days were, but rather the first step in creating a new culture — not only in the face of the devastation of AIDS, but as a way to combat it”. Yet for gay men who are exploring barebacking and talking about it in psychotherapy, it is especially urgent that the therapist with whom they are doing this self-examination be gay affirmative, sex positive, and conversant with the impact of homophobia on gay men’s psyches so as not to inadvertently add to or minimize any shame the person may already be experiencing about this proscribed behavior. In the next chapters, we look at what social scientists have uncovered in researching why gay men are having sex without condoms.
