Halkitis PN, Parsons JT. Intentional unsafe sex (barebacking) among HIV seropositive gay men who seek sexual partners on the internet

New York University, Department of Applied Psychology, New York, NY 10003, USA.
AIDS Care (Impact Factor: 1.6). 07/2003; 15(3):367-78. DOI: 10.1080/0954012031000105423
Source: PubMed


While unsafe sex has been reported throughout the HIV epidemic, the underlying assumption has been that most persons do not seek to purposely ham unprotected sex. Within the gay community, the term 'barebacking' has emerged to refer to intentional unsafe anal sex. The prevalence of barebacking is evidenced among gay men, particularly those who are HIV-positive, by the number of internet sites devoted to barebacking and the number of men seeking sexual partners through the use of the internet. To gain insight into barebacking, a sample of 112 HIV-positive gay men were recruited from internet sites where men seek to meet each other for sex. The major it of participants (84%)reported engaging in barebacking in the past three months, and 43% of the men reported recent bareback sex with a partner of unknown serostatus. These results indicate the potential for widespread transmission of HIV to uninfected men by the partners they meet on the internet. Analyses revealed that men who reported bareback sex only with HIV-positive partners scored lower in sexual adventurism than those who had bareback sex regardless of partner serostatus. A significant correlation was observed between defining masculinity as sexual prowess and intentional unprotected anal sex. There are serious implications for HIV prevention efforts, in that internet-based education should be a priority in order to reach men who rely on this mechanism to find sexual partners.

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Available from: Jeffrey T Parsons, May 20, 2014
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    • "Some authors (e.g. Galatowitsch et al., 2005; Remien et al., 1995; Wolitski, 2005) have noticed external factors such as the advance of highly active therapies for HIV (HAART therapies) (Crepaz et al., 2004; Stephenson et al., 2003), the spread of new cyber-spaces to find partners who do not want to engage in safer sex practices (Blackwell, 2008; Halkitis and Parsons, 2003; Ross et al., 2005) and even the role of the use of recreational drugs to engage in unprotected anal intercourse (Greenwood et al., 2001; Wilton, 2011; Wilton et al., 2005). In the particular case of Spain, since data reports a huge increase in new HIV-infections between MSM (Centro Nacional de Epidemiologıá, 2012), 3 many studies have tried to determine individual and social reasons for engaging in unprotected sex but have talked obliquely about bareback sex practices (Centro Nacional de Epidemiologıá, 2012; Ferna´ndez-Da´vila, 2007, 2009; Rojas, 2004, 2007). "
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    • "Finally, there is a great deal of attention, fear and avoidance in the gay community surrounding the reduced disclosure of HIV status to one's sexual partners, which may result in a greater likelihood of serodiscordant sexual partners (Poindexter & Shippy, 2010). This is a bidirectional relationship, however, with both HIV-negative and HIV-positive men inferring that a lack of discussion and willingness to participate in condomless intercourse implies seroconcordance; this is a phenomenon identified by early studies of HIV and gay and bisexual men (Gold & Skinner, 1993; Halkitis & Parsons, 2003; Parsons et al., 2005, 2006; Suarez & Miller, 2001). This pattern of assumptions has been highly stable throughout the history of the pandemic, and does not appear to have shifted over time. "
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    ABSTRACT: Abstract Objective: HIV-related stigma is a major driver of poor prognosis for the treatment and reduced spread of HIV. The present article provides a qualitative analysis surrounding various themes related to stigma and shame as a result HIV Design: Eight gay men recruited from a community HIV clinic contacted the researchers in response to a study involving participation in a structured, 8-week group intervention for HIV-related stigma. Following this group, three men took part in open-ended interviews about their thoughts and experiences. Methods: IPA (interpretative phenomenological analysis) was used to examine the participants' experiences surrounding shame and stigma related to living with HIV. Results: Three superordinate themes were identified: social support and the disclosure of serostatus, stigma associated with serosorting, and attempts to negotiate a spoiled identity. Conclusion: In San Francisco, a city with a great deal of acceptance surrounding HIV and a large, politically active community of persons living with HIV, gay men continue to struggle with disclosure and stigma. This stigma may be an unexpected result of a high degree of HIV-testing and attempts by both HIV-positive and negative gay men to practice serosorting.
    Psychology & Health 12/2013; 29(5). DOI:10.1080/08870446.2013.871283 · 1.95 Impact Factor
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    • "According to a longitudinal study that reported a positive Nattrass association between practicing unsafe sex and HIV optimism, the rise in unsafe sex over time was unrelated to such attitudes and thus could not be explained by them (Elford, Bolding & Sherr, 2002, p. 1542). The rise in unsafe sex may be a consequence of factors other than the availability of HAART — factors such as the replenishment of individuals who enjoy unsafe sex in the population (Boily, Godin Hogben, Sherr & Bastos, 2005), increasing use of 'poppers' (Cox, Beauchemin & Allard, 2004), the rise of Internet dating (Elford et al., 2002; Halkitis & Parsons, 2003), broader changes in sexual culture towards less open discussion of HIV (Morin, Vernon, Harcourt, Steward, Volk, Riess, Neilands, McLaughlin & Coates, 2003) and safe-sex fatigue (Sepkowitz, 2000; Cox et al., 2004). If the rise in new HIV infections is unrelated to HAART, then rolling out HAART to more people will reduce the number of new infections (Blower et al., 2000). "
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    ABSTRACT: This paper shows how two publicly available epidemiological modelling packages, namely the Spectrum AIDS Impact Model and the ASSA2003 AIDS and Demographic Model, predict very different impacts from rolling out highly active antiretroviral treatment (HAART) on new HIV infections. Using South Africa as a case study, it shows that the ASSA2003 model predicts a significant drop in new HIV infections as HAART is rolled out, whereas the Spectrum model assumes that HAART does not have a preventative impact (and in fact generates a small increase in new HIV infections). Users will thus draw different conclusions about the public health benefits of HAART depending on which modelling package they use. Despite being presented as a policy-oriented modelling tool capable of exploring 'what if' questions about the impact of different policy choices, the Spectrum model is illequipped to do so with regard to a HAART rollout. Unlike Spectrum, ASSA2003 is more flexible and its assumptions are clear. Better modelling and more information (including about the relationship between HAART and sexual risk behaviour) is required to develop appropriate public-policy modelling for the HAART era.
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