Experts agree that the riskiest form of sex for transmitting HIV is unprotected anal intercourse (UAI) (Vittinghoff, Douglas, & Judson, 1999). UAI, now known as “barebacking,” has also been called “raw sex,” “natural sex,” and “uninhibited sex.” Since the onset of the AIDS epidemic, there have always been some gay men who refused to practice safer sex, though aware that condoms could mitigate the risk of contracting HIV through anal sex (Gauthier & Forsyth, 1999; Goodroad, Kirksey, & Butensky, 2000; Halkitis, 2000; Halkitis & Parsons, 2003; Halkitis, Wilton, Parsons, & Hoff, 2004; Mansergh et al., 2002; Suarez & Miller, 2001).
Some chose to disbelieve that HIV causes AIDS. Others were unwilling to sacrifice their sexual pleasure for possible longevity, and others deliberately sought to place themselves in harm’s way. Some of the men today who are having unprotected sex are the same people who always had sex in this manner.
It is important to understand that men were barebacking even during the earliest days of the AIDS epidemic, though the term was not used in print until 1997, and that the behavior has never completely stopped. As early as 1990, research conducted in San Francisco indicated that 18 percent of men who identified themselves as exclusively gay had engaged in the practice of UAI (Bartolomeo, 1990) at least once in the past year. Chuck Frutchey (1988), then education director of the San Francisco AIDS Foundation, stated that “this finding indicated that helping gay men to resist the temptation to slip back to unsafe sex practices was (even then) more of a problem than getting them to adopt safe-sex habits initially. Clearly, where we need to put a lot of effort now
is in maintenance programs. We do not have to teach gay men how to have safer sex — they know that already. What we have to do is have programs that encourage them to maintain safe-sex behavior.”
It seems as if little has changed in the years since Frutchey made this dire prediction. But one thing that has evolved is the variety of ways that sex without condoms is now viewed, interpreted, and understood 30 years into the AIDS epidemic. For many gay men in the 21st century, there is not the same strong community norm about having safer sex as existed during the height of the AIDS epidemic. How has this change come about? Is it an understandable and normal evolution as well as possibly dangerous and maladaptive? What role does gay-affirmative psychotherapy have in answering these tough questions and working effectively with gay men who bareback who want to examine this aspect of their behavior? And what would make a gay man become ambivalent
about taking precautions not to contract or spread an incurable disease?
The rise in unsafe sex has been discussed within the gay community for more than a decade. The mainstream media began covering the issue in 1994, when the New York Times magazine ran a first-person account by a gay HIV-positive Generation X-er who did not describe unsafe sex but did announce himself as part of the “second wave” of gay seroconversions (going from HIV negative to HIV positive). He wrote, “At this point, let’s face it, we’re the least innocent of ‘victims’ — we have no excuse, the barrage of safe sex information, the free condoms, blah, blah, blah. . .”. When gay journalist Michelangelo Signorile (1994) and prominent queer theorist Michael Warner (1995) both wrote about their own unsafe sexual encounters, these public revelations highlighted the extent to which safer-sex education programs were failing. Warner’s description in The Village Voice of anal sex without a condom illustrated the degree to which intellectual sophistication and an openly gay identity did not guarantee consistency regarding safer sex practices. The problem of gay men having sex without condoms entered mainstream national consciousness in 1996, when a New York Times magazine cover story (Greene, 1996) featured Mark Ebenhoch, a white
gay man in his thirties, who became HIV-positive due to his having intentionally had unsafe sex. Most of the letters occasioned by these articles expressed shock and outrage, while a minority were relieved to finally have this issue aired publicly.
Other people were addressing the issue of barebacking even before the term first appeared in print. Prominent porn star and author Scott O’Hara publicly extolled the virtues of having unsafe sex. In 1995, O’Hara wrote an editorial entitled “Exit the Rubberman” in Steam, a journal he published that was devoted to sex in public spaces. He wrote: “I’m tired of using condoms, and I won’t” (O’Hara, 1995). The letters from readers — admittedly self-identified as people into sexual adventurism — were overwhelmingly favorable. O’Hara, who has since died of AIDS, and other HIV-positive men restated their positions in magazines such as POZ and The Advocate. Letters to the editor against the anticondom statements voiced by O’Hara and others revealed the frustration, fury, and sadness of gay men who had worked tirelessly since the start of the AIDS epidemic to reduce infection rates and who had buried friends and lovers. They were appalled that the attitude of O’Hara and others who shared his ideas about barebacking might result in a return to those terrible times of death and grief. Another group of readers voiced relief that this difficult issue was at last being brought into the public discourse. The term “barebacking” first appeared in print in POZ, in an article entitled “My Turn: Riding Bareback,” in which the late AIDS activist and writer Stephen Gendin (1997) described the thrill of not using condoms during anal sex with other HIV-positive men. Gendin explained that “barebacking,” which traditionally refers to riding horseback without a saddle, was the vernacular term for UAI. After his article appeared, POZ was flooded with letters, the majority of which condemned Gendin for glamorizing a behavior that would lead men to court death.
In 1997 porn star Tony Valenzuela inadvertently took on a public role as the poster boy of unsafe sex. The event that propelled Valenzuela into national notoriety occurred at that year’s Creating Change Conference in San Diego. Creating Change is the National Gay and Lesbian Task Force’s annual conference for leaders of the gay movement as well as for community activists. In an impromptu speech at a community town hall meeting, convened to discuss recent attacks on public sex and promiscuity by gay conservatives, Valenzuela spoke of his work in the sex industry as an escort and as the first openly HIV-positive porn actor in the U.S. The furor was caused by this remark: “The level of erotic charge and intimacy I feel when a man comes inside me is transformational,
especially in a climate which so completely disregards its importance.” Few who heard Valenzuela speak seemed to pay attention to his cautionary caveat: “When I talk about having unprotected sex, I am speaking for myself, and not as a proponent of condomless sex for all.” Yet as Stephen Gendin (1999a) reported in an article entitled “They Shoot Barebackers, Don’t They?” Valenzuela’s clearly stated position about not advocating condomless sex for all was undercut by his defiant assertions: “I am a sex gourmet in a community serving sexual TV dinners . . . and I have placed myself in the middle of HIV anarchy.” His speech to a room of 2000 gay and lesbian leaders created an immediate uproar that degenerated into a shouting match, as Valenzuela’s few defenders tried to articulate responses to the almost universal outrage and condemnation. This was but an early salvo fired in the ensuing debates around barebacking that have been taking place ever since.
The debate reappeared in the mainstream with a 1997 Newsweek article called “A Deadly Dance” (Peyser, 1997), which discussed the phenomenon of gay men not using condoms. Barebacking “arrived” when it made it into a 1998 episode of the television series ER. The story involved a gay sex worker describing how customers paid him a higher fee for bareback sex. That same year, former Miss America Kate Shindle weighed in on the issue in an Advocate article entitled “Barebacking? Brainless!” She predicted that funding for AIDS prevention would cease if gay men’s flagrant disregard for safer sex practices came to the attention of government agencies. It was too late; by then barebacking was already a part of public discourse. Then, Vice President Al Gore referred to barebacking in a conversation with the president’s AIDS Advisory Council (Scarce, 1999a).
The print controversy about barebacking continued in 1999, when POZ published an article by San Francisco AIDS activist Michael Scarce (1999b) called “Safer Barebacking Considerations,” in which he developed strategies for helping reduce the harm associated with barebacking, which he explicitly stated were not a set of HIV guidelines and were “intended only for gay men who have already decided not to use condoms for anal sex.” In his opening column in that issue of POZ, publisher Sean Strub acknowledged that Scarce’s article was controversial, but also wrote that “safer barebacking comes out of a grassroots, Our Bodies, Ourselves, tradition of taking charge of one’s own health” (referring to the title of the first feminist book published about women’s health). As Carballo-Dieguez and Bauermeister (2004) note: “Since then, barebacking has generated heated controversy in gay circles. Some gay writers have strongly condemned the behavior (Lenius, 1999; Ricks, 1999; Signorile, 1997, 1998, 1999, 2001). Others have seen in it an expected reaction to absolutist HIV prevention messages (e.g., ‘Use a condom every time’) and have been somewhat more accepting of it” (Gendin, 1997; Mallinger, 1998; Gendin, 1999b; Mirken, 1999; National Sex Panic Summit, 1997; Rofes, 1999; Salyer, 1999; Scarce, 1998; Sheon & Plant, 1997).
Never one to shy away from controversy, Stephen Gendin (1999b), in another column for POZ, discussed how he and his boyfriend, Kyle “Hush” McDowell, had been barebacking and that it ultimately resulted in Hush’s becoming infected. In a companion article, Hush (McDowell, 1999) described that his wanting to “desperately hold Stephen’s interest” was the major rationale why he allowed himself to have “raw sex within hours of meeting,” which resulted in his seroconversion. Hush had come out as a gay man after the advent of HIV. He knew all about safer sex.
In January of 2003, Rolling Stone published an article entitled “Bug Chasers: The Men Who Long to Be HIV+” (Freeman, 2003), which chronicled the story of men who reportedly sought unsafe sex with the explicit intention of becoming infected. The story created another uproar, with the rhetoric about barebacking becoming highly polarized. Those who oppose barebacking labeled barebackers as “dangerous sex fiends” (Scarce, 1999a), and barebackers called their detractors “condom Nazis” (Scarce, 1999a).
In defense of condomless sex, O’Hara (1997) wrote, “I may die at a younger age than my gay brothers who are more cautious, who limit the number of their sexual contacts, and than my straight brothers who, presumably, are rigidly monogamous. And you know something? I decided a long time ago that it is worth it”. O’Hara in fact died on February 18, 1998, at age 36, from AIDS-related lymphoma.
A few years later, in 2000, Tim Dean wrote an indirect response to O’Hara: “Unfortunately, this kind of implicit cost-benefit analysis completely misses the point that unsafe sex is a social activity as well as a question of individual decision making. This is in fact perhaps the key point regarding barebacking. It does not merely affect an individual, but also the men he is sexually active with as well as the community within which he lives. Unlike other risky behaviors such as smoking, drinking, and substance abuse (which arguably can be indulged as solitary pursuits), unsafe sex always directly involves somebody else” (Dean, 2000). Dean’s comments speak to the concept of “sexual ecology” formulated in the context of AIDS by Rotello (1997), and maintain that there is the need to examine barebacking using an ecological or holistic framework that looks at the individual as well as the social and communal relationships within which he is living.
