A systematic method was used to elicit the names of the six most popular free Internet sites used by gay men and other men who have sex with men in New York City, to meet partners for "bareback" sex. An analysis of the sites characteristics shows that men can use mainstream Internet sites, gay-specific sites, and sex-focused sites free of charge to search for bareback sex partners, selecting by location, physical attributes, sexual mode, HIV-serostatus, and other characteristics. Many individuals use these sites, producing the impression that bareback sex is not an oddity confined to just a few. The official language of the bareback sites associates bareback sex with masculinity and courage, prioritizing pleasure, freedom, choice, and intimacy over HIV-transmission prevention. The sites facilitate sexual experimentation and the expansion of bareback networks. Although some consider bareback sex to represent a failure of HIV prevention, this study suggests that harm reduction strategies may be viable within bareback networks.
[Show abstract][Hide abstract] ABSTRACT: Although some rectal douches result in surface epithelium loss and potential increase of HIV transmission, men who have sex with men (MSM) continue to use them. We describe the prevalence of this practice among MSM engaging in unprotected receptive anal intercourse (URAI) in risky circumstances. A multiethnic sample with overrepresentation of HIV-negative MSM who had URAI in the previous year was recruited exclusively through the Internet. Participants were 105 MSM (78 HIV-negative, 27 HIV-positive). A total of 53% of HIV-negative and 96% of HIV-positive men douched in preparation for sex, most of them frequently or always, mainly for hygienic purposes. 27% of HIV-negative and 44% of HIV-positive douched after sex, partly believing douching protected from infections. Douching practices started around age 25. Regression analyses found the association between HIV status and douching occasions persisted after controlling for demographic characteristics and number of URAI occasions. Rectal douching in preparation for sex is common among men who practice URAI. This population could benefit from alternatives to condoms, such as rectal microbicides. Given the popularity of pre-coital douching and its frequency, a harmless rectal douche that could deliver a rectal microbicide could have great acceptability.
AIDS and Behavior 09/2007; 12(6):860-6. DOI:10.1007/s10461-007-9301-0 · 3.49 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Condom use is the best available strategy to prevent HIV infection during sexual intercourse. However, since many people choose not to use condoms in circumstances in which HIV risk exists, alternatives to condom use for HIV prevention are needed. Currently there are several alternative bio-medical HIV-prevention products in different stages of development: microbicides, vaccines, post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP). Seventy-two men who have sex with men (MSM) who took part in a study on Internet use and intentional condomless anal intercourse were asked about these four products during a semi-structured interview. The questions explored knowledge and acceptability of all the products and willingness to participate in microbicide and vaccine trials. Qualitative analysis of the data suggests that these men had virtually no knowledge of PrEP, very limited knowledge of microbicides, some information about PEP and considerably more knowledge about vaccines. Reactions towards the products were generally positive except for PrEP, for which reactions were polarized as either enthusiastic or negative. With the exception of PrEP, many men expressed willingness to use the products in the future. Most men would be willing to participate in trials for microbicides and vaccines if given basic reassurances. Concerns over negative side effects and preoccupation with possible infection were some of the motives given for non-willingness to participate in a vaccine trial. These results should inform the development of future trials of biomedical prevention products.
AIDS Care 02/2008; 20(1):106-15. DOI:10.1080/09540120701449096 · 1.60 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Gay men’s use of the Internet to meet other gay men for social and sexual purposes is now so common that some predict the end of gay bars and other face-to-face hooking-up settings. There is speculation that the Internet is responsible for increases in sexually transmissible infections and HIV incident infections in a number of cities, both in the USA and elsewhere. In New York City, where this study took place, the use of Internet by men to meet other men seeking sex without condoms, called bareback sex, has created concerns among public health and gay community HIV/AIDS workers. Is the Internet at fault here? If so, how does it work to incite such risk-taking, if it is that? If not, what then is going on inside these barebacking sites? This study of six popular bareback sites seeks to understand the nature of this new online sexual culture, by investigating, first, the actual sites as cultural production through the methodological approach of cybercartography. Then, in a second stage, users of these sites were interviewed. During the cybercartography, however, the investigation suggested that the recent conceptual recuperation of masculinity as an analytic in gender studies might offer some value in understanding what was happening sexually and culturally on these sites. Men’s sexual desires were also revealed to be forming and reforming in relation to the sites, and issues of race and ethnicity emerged to challenge singular notions of masculinity. This paper suggests that masculinity itself might need some recalibration if it is to come to grips with the performative richness of the Internet and its sexual potential. We may also need to understand these sites not simply as inciting risk-taking behaviour but as evolving sexual cultures in their own right.
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