An HIV negative prevention activist goes through the latex looking glass to discover who's doing it raw, and why.
Every Thursday through Sunday night in
San Francisco's Castro district, someone named Marshall uses his
house to host a party for other gay men who share a similar sexual
interest: no condoms. Admission is $8, and after I pay, Marshall
hands me a piece of paper. "This is a bareback party," the house
rules read. "It is assumed all guests are HIV+ or have made the
decision to attend this kind of party. Therefore, there will be no
discussion of status, illness or medicine." Partygoers must also
sign a statement of their intention not to infect anyone with HIV.
Whether or not they mean it, this relieves the host of any
responsibility under the new California law that criminalizes HIV
transmission. After signing in, I peel off my clothes, stuff them
into a white trash bag labeled "Michael S." in black magic marker
and, with a sense of trepidation, proceed downstairs into a large
bedroom occupied by a dozen naked men in various positions of sexual
activity. A red bulb provides the only light, casting an eerie glow
over the room. A TV screen flickers with a porn video. The men are a
diverse group, running the gamut in age, ethnicity and body type.
Moving between the bodies, I take a seat and watch the center of the
action -- two tops take turns with a bottom. The sex is silent,
serious and very intense. It continues for what seems like an hour,
finally culminating with the two tops each getting off inside the
bottom. Afterward, he remains on his hands and knees, waiting for
others to mount him. During this pause, I find myself, as a
28-year-old gay man, wondering if this is what carefree sex was like
in the '70s. No one here but me betrays anxiety.
The late writer and porn star Scott O'Hara was the first to
lead the barebacking charge. In a 1995 editorial titled "Exit the
Rubberman," in Steam, his journal devoted to sex in public
spaces, O'Hara wrote: "I'm tired of using condoms, and I
won't ... , and I don't feel the need to encourage
negatives to stay negative." The letters from readers -- admittedly
a group self-selected for sexual adventurism -- were overwhelmingly
favorable. As O'Hara and other HIV positive men restated their
positions in such magazines as POZ and The Advocate,
there was a sense that they were mining a long-buried, pre-AIDS
memory -- the sharing of semen -- and reclaiming its rich symbolic
meanings. These anti-condom statements were more than enough to
frustrate, infuriate and sadden the majority of gay men who fought
so diligently over the years to reduce infection rates while burying
their loved ones.
In September 1997 the debate leapt from the gay press into full
public view with a piece in Newsweek called "A Deadly Dance."
Soon, former Miss America Kate Shindle was commenting, speculating
in a February 1998 Advocate commentary, "Barebacking?
Brainless!" that funding for AIDS prevention would dry up if
government agencies took notice of gay men's supposed disregard for
public health. Even Vice President Al Gore used the term barebacking
in his conversation with the President's AIDS Advisory Council. In
an episode last season of the popular television series ER, a
gay sex worker described how his customers paid him extra for
bareback sex.
Since its public debut over three years ago, barebacking -- also
called raw or skin-to-skin sex -- has been simultaneously condemned
and sensationalized by the media. The debate is stuck between two
hyperpolarized camps, with antibarebackers screaming, "Dangerous sex
fiends," while barebackers counter with "Condom Nazis." Meantime, a
new sexual subculture has emerged, organized around the no-condoms
creed. Driven underground but swelling in numbers, this community
flourishes in private houses and especially on the Internet, where
its members -- not all have HIV -- can fantasize, experiment and
connect with others, free from the stigma attached to openly
soliciting unsafe sex.
In a sense, Scott O'Hara and other self-proclaimed barebackers
were merely publicizing a widely recognized but rarely disclosed
fact. For years now, public health experts have told HIV positive
gay men to err on the side of caution by using condoms even with
other positives, though the scientific jury on reinfection is still
out. While many HIVers have complied -- condom use was viewed in the
late '80s as a virtual communal duty -- many others have not. They
are unwilling to abandon an act of such fundamental importance as
skin-to-skin sex for an as-yet-unproved harm. Last summer,
researchers documented the first case of multidrug-resistant HIV
transmission -- from an HIV positive man to his HIV negative
partner. AIDS organizations used the case to reissue a condom-code
clarion call. Then, in September, a Centers for Disease Control and
Prevention epidemiologist made the first scientific pronouncement
that reinfection by different strains of HIV is a fallacy. Other
researchers immediately disputed these claims. Meanwhile, many gay
men with HIV assume that no definitive news is good news, and
continue condomless.
Many prevention experts lay the blame for barebacking on
protease-based regimens (and, to a lesser extent, post-exposure
prophylaxis treatment -- the misnamed "morning-after pill") for
popularizing the idea that AIDS is a chronic, manageable disease,
but some barebackers call this passing the buck. "I think
barebacking was inevitable," Zach, a 36-year-old lawyer and
barebacker, says. "Protease is helping men live longer, but gay men
have finally had it up to here. After 18 years of living in doubt
and crisis, men don't want to face a lifetime of wrapping themselves
in latex." In fact, the emergence of this new sexual subculture also
coincides with an ongoing crisis in HIV prevention, including recent
attacks on the condom code from such gay psychologists as Walt
Odets, PhD, such morality-and-monogamy advocates as Gabriel Rotello
and such "post-AIDS" sex-lib theorists as Eric Rofes.
Meantime, advances in treatment continue to multiply the areas of
doubt through which gay men wander. The relationship between HIV in
blood and HIV in semen remains murky, and many barebackers are left
to hope -- but not know -- that an undetectable viral load in their
or their partner's blood might reduce the likelihood of
infection. Indeed, the questions prevention experts are most
frequently asked are not about basic transmission, but rather these
"gray areas" -- oral sex, pulling out, pre-come and so on. The
national AIDS establishment's polarization of all behavior into
either "high risk" or "low or no risk" leaves many gay men -- whose
behaviors reside somewhere between these extremes -- unsupported in
their sexual decisions.
Distinct from an infrequent slip-up, drunken mishap or safer-sex
"relapse," barebacking represents a conscious, firm decision to
forgo condoms and, despite the dangers, unapologetically revel in
the pleasure of doing it raw. Some people use the word barebacking
to describe all sex without condoms, but barebackers themselves
define it as both the premeditation and eroticization of unprotected
anal sex. Michael McKey, a producer of a new line of bareback porn
videos, puts it this way: "Barebacking is an active decision -- and
that's very different from just sort of passively letting
unprotected sex happen."
To barebackers, it's the meaning of skin-to-skin sex that
matters; to antibarebackers, it's the consequence -- the risk of
deadly (and other) diseases. Generally, the public views all
barebacking unilaterally as "unsafe sex" and as the opposite of
"safer sex." In my own effort to make sense of why some men choose
to eliminate condoms, I've found it enormously helpful to consider
barebacking in a different framework: like safer sex, on a continuum
of "un-safety" with varying degrees of protection and danger
(pulling out before ejaculation is less "unsafe" than not). It's
worth noting that as the risk of HIV infection escalates, so do
moral judgments. This is why raw sex between positive men is often
merely frowned upon, but when the partners are serodiscordant, words
like murder and suicide enter the discussion. It also
explains the notion that an HIVer who tops is more "guilty" than one
who bottoms.
Zach, who is HIV negative, barebacks only as a top when he has
sex with positive men -- in his mind, an act relatively low on the
"unsafer" continuum. He arrived at skin-to-skin sex through the
practice of negotiated risk (a harm-reduction strategy common
outside the United States): He'd been in a series of relationships
with men where they both repeatedly tested negative and finally
dispensed with condoms. "After a few of those relationships, I
decided not to use condoms at all anymore," he says. "Barebacking is
an incredible experience, and it's tremendously difficult to go back
to latex."
But the decision to abandon condom use is not always a one-way
street. Dave, an HIV negative man who once threw himself into the
latex-free life for several months, is one example: "I decided to
stop barebacking because of the potential health risks -- and not
just HIV -- although I definitely feel that latex negatively affects
my sex life." But he says he is still very much drawn to raw sex --
"somewhat like a moth to a flame." Health concerns that drive guys
like Dave back to condoms include such STDs as herpes, hepatitis,
gonorrhea and anal warts. And for positive barebackers, these STDs
can significantly impair the immune system, accelerating the
progression of HIV disease. The risk that has placed barebacking at
the center of national debates on gay sexual mores, of course, is
that of HIV. Many HIV negative men are barebacking, and while some
attempt to do it only with other negative men, it's impossible to be
absolutely sure of a partner's serostatus.
Eighteen years into the HIV
holocaust, a gay man -- regardless of serostatus -- is likely to
have an immensely complex relationship not only to unsafe sex but to
the virus itself. Barebackers like Zach focus on the positive values
of semen exchange: "There's no better way to bond with a man than to
give or receive sperm. A lot of bottoms take it into their bodies
and keep it there as a way of remembering the sex. They want to feel
it inside them and keep experiencing that closeness. It's a physical
expression of intimacy."
Yet as Walt Odets, William Johnston and other experts on the
psychology of HIV negative men have documented, there are also other
emotions drawing them to the virus, including survivor guilt, a
sense of inevitability about the prospect of seroconversion, an
identification of AIDS with gayness, an association of
seroconversion with a positive life transformation and more. Pete, a
33-year-old gay man, expresses this ambivalence. "I was so afraid of
becoming positive for such a long time," he says, "and once that
happened, I felt relief. I also decided I didn't want to spend my
whole life going without the sex I love the most." For many,
liberation from the necessity of condom use with other positive men
presents a certain appeal. A popular and ironic barebacking slogan
coined by Stephen Gendin in these pages almost two years ago sums it
up: "Membership has its privileges."
Bare sex's "moth to a flame" seductiveness has exploded into an
elaborate social network that Scott O'Hara could hardly have
imagined in 1995. With "health monitors" patrolling commercial sex
venues, on the lookout for patrons who dare to break the rules,
barebackers have responded by hosting private parties in their own
homes. At The Bareback House in San Francisco, Marshall has even
created events catering to special interests, including "Fill a
Hole" parties, during which one or two designated guests serve as
bottoms for the 20-plus tops. Some parties in other cities are
arranged for men of a particular serostatus: positive only, negative
only or mixed. One invitation instructs participants to wear a
bandanna to signify whether they want guys to "unload" in them. Lest
anyone believe these parties are confined only to urban gay meccas,
they are also organized in cities such as St. Louis, Oklahoma City,
Phoenix and Indianapolis.
Websites such as XtremeSex, IRC (Internet Relay Chat) channels
and America Online (AOL) chat rooms have sprung up, seemingly out of
nowhere. There are now more than 80 different bareback electronic
mailing lists ("listservs") for men of certain body types,
geographic locations and shared sexual tastes. The most popular is
run by a man named Ed and boasts more than 1,400 subscribers. Ed
estimates that 60 percent are HIV positive and the rest are HIV
negative or uncertain of their status. To keep the list from
erupting into a debate about the moral pros and cons of barebacking,
the listserv's No. 1 rule is no discussions of AIDS. Men can
identify their HIV status, but nothing more.
In addition to the Internet, barebackers have appropriated a
number of time-honored gay male methods for cruising, including the
'70s system of visually communicating a preference for specific sex
acts by wearing color-coded handkerchiefs. After lengthy Internet
discussion, barebackers chose their own hanky: dark blue (anal
intercourse) with white dots (semen).
While many barebackers are committed to staying uninfected and
protecting their partners from HIV, the XtremeSex website caters to
those who are not. In operation for more than two years and open to
all gay men -- regardless of serostatus -- it highlights the erotic
appeal of HIV-infected semen. XtremeSex offers hundreds of personal
ads including those from "bug chasers" (men looking to become
infected or exposed to HIV) and "gift givers" (men who eroticize
infecting or exposing others to HIV). "Hot hard-body muscular bottom
looking to be gang-banged by as many poz guys who want it. I will do
whatever you want. No limits at all. I need your charged loads" is a
characteristic personal on the XtremeSex website.
Rare exceptions to the barebacking norm, these men prize not just
unprotected anal sex or even semen but HIV itself as the ultimate
intimacy to share with another. In a mind-boggling feat of symbolic
reversal, they have taken the dread and deadliness of the virus and
transformed it into desire and regeneration. For them, sharing
uninfected semen is insufficient because it provides only a
temporary bond -- the come dries up, leaving only the memory of the
experience. But "charged loads," in the XtremeSex worldview, offer a
kind of permanent partnership, a connection outside of time. Once
you're infected, you're infected for life. Over and over on the
XtremeSex website this fantasy plays itself out, and XtremeSexers
have used their considerable knowledge of HIV pathogenesis to
elaborate it. From the science of how the virus invades -- and then
is incorporated into -- the host cell, combining the DNA of one
organism with another to make a new form of life, these men have
woven a tale of romance. In this way barebacking is equated with
"breeding" and infection with "impregnation." Some HIV negative bug
chasers have gone so far as to attempt to consciously choose the
individual gift-giver who will "father" their HIV infection. For
these men, seroconversion has become a rite of passage rather than a
chance occurrence, couched in metaphors of pregnancy.
One HIV positive man named Paul, 45, is in the process of
becoming a gift-giver to a 21-year-old HIV negative sex partner.
Paul has delayed "giving the gift." Though they have had sex without
condoms in the past, Paul has never ejaculated inside his partner.
He has spent the last few months telling his friend about HIV and
its physical and emotional consequences. "I've talked with him for
quite some time so that he understands what he's getting into, and
evidently he feels it's controllable and wants it," he says. "As
long as he is clear on what he's asking for, I'd love to drain a
load up his hole. It turns me on knowing how much he wants my come
and how much he's willing to deal with to get it."
When pressed, Paul acknowledges the "twisted romantic" nature of
their relationship and the unequal power dynamics of their
difference in age. His tone of voice, so matter-of-fact, is almost
as disturbing to me as what he has to say.
The gap between public HIV prevention messages and gay men's
behavior behind closed doors is wider than ever, for a number of
reasons. Most early prevention strategies were grounded in fear and
shame, disallowing honest discussion of behavior that deviated from
the condom code. Current campaigns continue to paint such broad
brushstrokes ("Use a condom every time") that the audience for this
social marketing either tunes out or fails to identify with the
message. Further, a resistance to most harm-reduction strategies in
the United States has disempowered men from making informed choices
about the level of risk with which they are comfortable. It's worth
noting that extensive barebacking subcultures do not exist in other
countries such as Australia where sex-positive harm-reduction models
were instituted early on.
Offering his take, Zach, a former AIDS service organization
professional, says, "In other countries they focus on saying, 'If
you get fucked by someone whose status you don't know, use a condom
and don't let him come in you. Period.' But they don't try to scare
you about oral sex, pre-come and reinfection."
Many barebackers believe their subculture has coalesced in large
part as a backlash against all this. "What we're seeing now on the
Internet is just the beginning," Zach says. "AIDS groups are so out
of touch with their communities. They should think less about where
they're getting their funding and more about the communities they're
supposed to serve. They need to get a grip on our reality.
Otherwise, it's going to get a lot worse."
Rather than scapegoating barebackers for the shortcomings of HIV
prevention campaigns, a more productive approach would entail
outreach workers familiarizing themselves with the subculture. Like
it or not, as Zach says, men will continue to bareback, and they
deserve a set of noncondom strategies to help reduce the harm.
Acknowledging that "unsafer" behavior has its own continuum, a
harm-reduction approach to barebacking would enable men to make more
informed choices. For a presentation at last year's National Lesbian
and Gay Health Association Conference in San Francisco, I crafted a
draft model of "Safer
Barebacking Considerations." This approach has raised the ire of
old-guard administrators in the mainstream AIDS establishment. Tom
Coates, MD, director of the Center for AIDS Prevention Studies at
University of California, San Francisco, likens it to "strategies
for reducing the potential for killing someone while driving under
the influence of alcohol," he says. "People may make lots of
decisions, but that doesn't mean that we should endorse them,
especially without data."
In his response to the "Safer Barebacking Considerations," Devin
Kordt, founding director of Aggressive AIDS Prevention in San
Francisco, asks, "If the individuals do not value proven prevention
methods for anal sex, i.e., condoms, what makes you think they want
the equivalent of a personal lube endorsement?" In other words,
Kordt asserts that because barebackers have rejected one prevention
strategy, they will reject all others in their indiscriminate
recklessness.
The controversy continues with a growing recognition that
barebacking is neither a fad nor a glamorous buzzword. It remains to
be seen how politicized barebackers will become about their rights
and responsibilities. While it's unlikely that a contingent of
bareback advocates will march in this year's gay pride parades, this
community is increasingly visible. Take the example of "Xtreme '99."
Billed as a national barebacking "convention," it's a weekend
gathering this April in Dallas, Texas of hundreds of men from all
over the United States and other countries for bareback sex.
Before I attended barebacking parties, I believed I had mentally
prepared myself for what I would encounter, but my experiences left
me with a mix of intense emotions -- fascination, desire and dread.
Perhaps most frightening was my temptation to join in the
skin-to-skin action. But I limited my sex to what I usually do in
the absence of condoms -- blowjobs. Why? After much reflection, I
see that to me, the social stigma attached to writing honestly about
such an experience seems almost as damaging as the health risks
involved. While I had previously written about and intellectualized
barebacking, I was nonetheless taken aback by the reality of being
surrounded by the act.
My own thoughts on barebacking have shifted radically in recent
months, especially in regard to my stereotypes about the men
themselves. After the barebacking parties, I was overwhelmed by what
I perceived to be sex without limits, a lack of critical thinking
and short-sighted hedonism. Later, interviewing and interacting with
barebackers made me realize that they possess personal ethics,
political consciousness and self-control in addition to the relative
extremity of their sex.
These experiences have led me to believe that barebackers do not
deserve to be vilified, but rather more fully understood, and the
very real problems to which barebacking may contribute should also
be examined. In essence, barebacking represents the classic conflict
inherent to public health. But there's great difficulty in balancing
rights for people who make choices that are "extreme" with the
potential for collective burden and actual cost to be born by all of
us. A harm-reduction approach is merely the beginning, and doesn't
address what is perhaps the greatest danger currently surrounding
barebacking: the inability of community members and leaders to
discuss these issues with mutual understanding and respect.
SAFER BAREBACKING CONSIDERATIONS
This is not a set of HIV prevention
guidelines. Intended only for gay men who have already decided
not to use condoms for anal sex, these strategies may help
reduce the harm associated with barebacking, some advocates
believe. Here, harm should be interpreted more broadly than
HIV infection; these tips may also help reduce the risk of
other STDs. Bear in mind that much of this information is
anecdotal and debated by researchers.
- POPPERS AND VIAGRA
Dilated blood vessels
in the rectum caused by sniffing poppers make it easier for
viruses to enter your bloodstream, so if your partner
ejaculates inside you, you're wide open for infection.
Viagra works similarly -- increasing blood flow to the
pelvic region (facilitates erection) and to the rectum --
and poses similar risks.
- LUBRICANT
Use it generously to help
prevent tears that allow infection. Don't rely on saliva.
Nonoxynol-9 may afford limited protection against some STDs;
however, by irritating them, it may increase the urethral or
rectal tissues' susceptibility. One study of N-9 use in gay
men's rectums found it didn't create irritation that would
significantly increase risk of infection, but the medical
literature yields conflicting data. An over-the-counter
contraceptive gel, like Advantage 24, is unlikely to fully
coat the rectum and provide complete protection.
- EARLY WITHDRAWAL
Pulling out before
ejaculation may reduce risk. But since HIV and other
infectious agents are in pre-come, this method still poses a
risk.
- RATIONING
Limiting your barebacking over
time can reduce exposures and sex partners -- which may
decrease the risk of harm -- and allows time for healing of
tears or trauma in the rectum, urethra and outer skin of the
penis.
- NEGOTIATION
Try to talk with partners
about STD status, including HIV, herpes, hepatitis and human
papilloma virus (causes anal and genital warts). If talk
isn't part of your sex, you may be able to see or feel
warts, lesions, discharge or other physical signs of STDs.
But one may be asymptomatic yet still infectious. Decide
ahead of time if you're willing to come in your partner or
allow him to come in you, then assess your ability to trust
your mutual adherence to that agreement.
- BEFORE- AND AFTER-CARE
Douching or using
enemas with harsh detergents can strip away protective cells
in the rectum. If you use an enema before sex, try warm
water. Be careful not to create tears inside or around the
anus. Some believe lubes, especially oil- and silicon-based,
can trap germs against the skin, increasing likelihood of
infection. Douching with a spermicidal foam or homemade
vinegar-and-water solution after sex may render some
infectious agents inactive, but little research has been
conducted. If having sex with multiple partners over a short
time, don't douche until after the last one. Try to urinate
right after sex: Urine's acidity can help clean out the
urethra.
- IMMUNITY
The more stressed, under the
influence of alcohol or drugs, tired or ill you are, the
higher the chance that an exposure will result in infection.
If you have HIV and another STD, you're more likely to
transmit HIV. If you're HIV negative with an STD, you're
more likely to become infected.
- VACCINATIONS
Get vaccinated for hepatitis
A and B. Barebacking exposes you to fecal matter and other
hepatitis-carrying fluids.