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Barebacking: A Review of the Literature

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Abstract

This article synthesizes the peer-reviewed literature about barebacking, an HIV risk behavior that is generally understood as intentional unprotected anal intercourse between men where HIV transmission is a possibility. Of the 42 academic reports identified in the Anglophone literature, the greatest attention is given to U.S. publications and empirical projects. The variable nomenclature about barebacking is recognized and it is concluded that although epidemiological data suggest prevalence of barebacking varies across regions, time, and serostatus, the majority of men who have sex with men (MSM) do not intentionally seek out condomless anal sex. Findings show that macro-, meso-, interpersonal-, and intrapersonal level factors, such as homonegativity, community norms, partner intimacy, and drug use, converge to influence the likelihood that an individual will bareback. A conceptual framework to examine the reciprocal and dynamic relationships sustaining barebacking is proposed. In examining the theoretical and methodological limitations of the research about barebacking, the atheoretical nature of the studies, failure to report analyses conducted, and suboptimal measures are included among the study constraints. Furthermore, in research to date, the majority of participants have been white, urban, and gay-identified; thus, more research is needed to capture the viewpoints of diverse MSM communities. There has also been an overly individualistic focus on barebacking which needs to be tempered by greater consideration of the impact of macro- and meso-level factors upon MSM’s behavior. With respect to programmatic responses, more culturally bound strategies are called for.

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References

  • Adam, B. D. (2005). Constructing the neoliberal sexual actor: Responsibility and care of the self in the discourse of barebackers. Culture, Health & Sexuality, 7, 333–346.

    Article  Google Scholar 

  • Adam, B. D., Husbands, W., Murray, J., & Maxwell, J. (2005). AIDS optimism, condom fatigue, or self-esteem? Explaining unsafe sex among gay and bisexual men. Journal of Sex Research, 42, 238–248.

    Article  PubMed  Google Scholar 

  • Berg, R. C. (2008). Barebacking among MSM Internet users. AIDS and Behavior, 12, 822–833.

    Article  PubMed  Google Scholar 

  • Bimbi, D. S., & Parsons, J. T. (2005). Barebacking among Internet based male sex workers. Journal of Gay & Lesbian Psychotherapy, 9, 85–105.

    Article  Google Scholar 

  • Blechner, M. J. (2002). Intimacy, pleasure, risk, and safety: Discussion of Cheuvront’s ‘High-risk sexual behavior in the treatment of HIV-negative patients’. Journal of Gay & Lesbian Psychotherapy, 6, 27–33.

    Article  Google Scholar 

  • Bolding, G., Davis, M., Sherr, L., Hart, G., & Elford, J. (2004). Use of gay Internet sites and views about online health promotion among men who have sex with men. AIDS Care, 16, 993–1001.

    Article  PubMed  Google Scholar 

  • Bull, S. S., McFarlane, M., & King, D. (2001). Barriers to HIV/STD prevention on the Internet. Health Education Research, 16, 661–670.

    Article  PubMed  Google Scholar 

  • Carballo-Diéguez, A. (2001). HIV, barebacking, and gay men’s sexuality, circa 2001. Journal of Sex Education and Therapy, 26, 225–233.

    Google Scholar 

  • Carballo-Diéguez, A., & Bauermeister, J. (2004). “Barebacking”: Intentional condomless anal sex in HIV-risk contexts. Reasons for and against it. Journal of Homosexuality, 47, 1–16.

    Article  PubMed  Google Scholar 

  • Carballo-Diéguez, A., Dowsett, G. W., Ventuneac, A., Remien, R. H., Balan, I., Dolezal, C., et al. (2006). Cybercartography of popular internet sites used by New York City men who have sex with men interested in bareback sex. AIDS Education and Prevention, 18, 475–489.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention (CDC). (2001). HIV/AIDS surveillance report, 13, 1–4.

  • CDC. (2007, May). HIV/AIDS among men who have sex with men. Retrieved June 5, 2007 from http://www.cdc.gov/hiv/topics/msm/resources/factsheets/msm.htm.

  • Cheuvront, J. P. (2002). High-risk sexual behavior in the treatment of HIV-negative patients. Journal of Gay & Lesbian Psychotherapy, 6, 7–25.

    Article  Google Scholar 

  • Cole, G. W. (2007). Barebacking: Transformations, dissociations, and the theatre of countertransference. Studies in Gender and Sexuality, 8, 49–68.

    Google Scholar 

  • Crossley, M. L. (2002). The perils of health promotion and the ‘barebacking’ backlash. Health, 6, 47–68.

    Google Scholar 

  • Crossley, M. L. (2004). Making sense of ‘barebacking’: Gay men’s narratives, unsafe sex, and the ‘resistance habitus’. British Journal of Social Psychology, 43, 225–244.

    Article  PubMed  Google Scholar 

  • Dawson, A. G., Ross, M. W., Henry, D., & Freeman, A. (2005). Evidence of HIV transmission risk in barebacking men-who-have-sex-with-men: Cases from the Internet. Journal of Gay & Lesbian Psychotherapy, 9, 73–83.

    Article  Google Scholar 

  • Drescher, J. (2002). Barebacking: Psychotherapeutic and public health considerations. Journal of Gay & Lesbian Psychotherapy, 6, 1–5.

    Article  Google Scholar 

  • Elford, J., Bolding, G., Davis, M., Sherr, L., & Hart, G. (2007). Barebacking among HIV-positive gay men in London. Sexually Transmitted Diseases, 34, 93–98.

    Article  PubMed  Google Scholar 

  • Forstein, M. (2002). Commentary on Cheuvront’s ‘High-risk sexual behavior in the treatment of HIV-negative patients’. Journal of Gay & Lesbian Psychotherapy, 6, 35–43.

    Article  Google Scholar 

  • Gauthier, D. K., & Forsyth, C. J. (1999). Bareback sex, bug chasers, and the gift of death. Deviant Behavior, 20, 85–100.

    Article  Google Scholar 

  • Goodroad, B. K., Kirksey, K. M., & Butensky, E. (2000). Bareback sex and gay men: An HIV prevention failure. Journal of the Association of Nurses in AIDS Care, 6, 29–36.

    Article  Google Scholar 

  • Graydon, M. (2007). Don’t bother to wrap it: Online giftgiver and bugchaser newsgroups, the social impact of gift exchanges and the ‘carnivalesque’. Culture, Health & Sexuality, 9, 277–292.

    Article  Google Scholar 

  • Grov, C. (2004). “Make me your death slave”: Men who have sex with men and use the internet to intentionally spread HIV. Deviant Behavior, 25, 329–349.

    Article  Google Scholar 

  • Grov, C. (2006). Barebacking websites: Electronic environments for reducing or inducing HIV risk. AIDS Care, 18, 990–997.

    Article  PubMed  Google Scholar 

  • Grov, C., DeBusk, J. A., Bimbi, D. S., Golub, S. A., Nanin, J. E., & Parsons, J. T. (2007). Barebacking, the Internet, and harm reduction: An intercept survey with gay and bisexual men in Los Angeles and New York City. AIDS and Behavior, 11, 527–536.

    Article  PubMed  Google Scholar 

  • Grov, C., & Parsons, J. T. (2006). Bug chasing and gift giving: The potential for HIV transmission among barebackers on the Internet. AIDS Education and Prevention, 18, 490–503.

    Article  PubMed  Google Scholar 

  • Haig, T. (2006). Bareback sex, masculinity, silence, and the dilemmas of gay health. Canadian Journal of Communication, 31, 859–877.

    Google Scholar 

  • Halkitis, P. N. (2007). Behavioral patterns, identity, and health characteristics of self-identified barebackers: Implications for HIV prevention and intervention. Journal of GLBT Health Research, 3, 37–48.

    Article  Google Scholar 

  • Halkitis, P. N., & Parsons, J. T. (2003). Intentional unsafe sex (barebacking) among HIV-positive gay men who seek sexual partners on the Internet. AIDS Care, 15, 367–378.

    Article  PubMed  Google Scholar 

  • Halkitis, P. N., Parsons, J. T., & Wilton, L. (2003). Barebacking among gay and bisexual men in New York City: Explanations for the emergence of intentional unsafe behavior. Archives of Sexual Behavior, 32, 351–358.

    Article  PubMed  Google Scholar 

  • Halkitis, P. N., Wilton, L., & Drescher, J. (2005a). Introduction: Why barebacking? Journal of Gay & Lesbian Psychotherapy, 9, 1–8.

    Article  Google Scholar 

  • Halkitis, P. N., Wilton, L., & Drescher, J. (Eds.). (2005b). Barebacking: Psychosocial and public health approaches. New York: Haworth Medical Press.

    Google Scholar 

  • Halkitis, P. N., Wilton, L., & Galatowitsch, P. (2005c). What’s in a term? How gay and bisexual men understand barebacking. Journal of Gay & Lesbian Psychotherapy, 9, 35–48.

    Article  Google Scholar 

  • Halkitis, P. N., Wilton, L., Wolitski, R. J., Parsons, J. T., Hoff, C. C., & Bimbi, D. S. (2005d). Barebacking identity among HIV-positive gay and bisexual men: Demographic, psychological, and behavioral correlates. AIDS, 19(Suppl 1), S27–S35.

    PubMed  Google Scholar 

  • Holmes, D., & O’Byrne, P. (2006). Bareback sex and the law: The difficult issue of HIV status disclosure. Journal of Psychosocial Nursing, 44(7), 26–33.

    Google Scholar 

  • Holmes, D., O’Byrne, P., & Gastaldo, D. (2006). Raw sex as limit experience: A Foucauldian analysis of unsafe anal sex between men. Social Theory & Health, 4, 319–333.

    Article  Google Scholar 

  • Holmes, D., & Warner, D. (2005). The anatomy of a forbidden desire: Men, penetration and semen exchange. Nursing Inquiry, 12, 10–20.

    Article  PubMed  Google Scholar 

  • Huebner, D. M., Proescholdbell, R. J., & Nemeroff, C. J. (2006). Do gay and bisexual men share researchers’ definition of barebacking? Journal of Psychology & Human Sexuality, 18, 67–77.

    Article  Google Scholar 

  • Junge, B. (2002). Bareback sex, risk, and eroticism: Anthropological themes (re-)surfacing in the post-AIDS era. In E. Lewin & W. L. Leap (Eds.), Out in theory: The emergence of lesbian and gay anthropology (pp. 186–221). Chicago: University of Illinois Press.

    Google Scholar 

  • Léobon, A. (2003). Barebacking et culture de risque: Les usages sociaux d’Internet et le dévelopment d’une culture de risque u sein de la communauté homosexuelle [Barebacking and risk culture: Social uses of the Internet and development of a culture of risk within the homosexual community]. Le Journal du Sida, 155, 16.

    Google Scholar 

  • Mansergh, G., Marks, G., Colfax, G. N., Guzman, R., Rader, M., & Buchbinder, S. (2002). ‘Barebacking’ in a diverse sample of men who have sex with men. AIDS, 16, 653–659.

    Article  PubMed  Google Scholar 

  • Minium, E. W., King, B. M., & Bear, G. (1993). Statistical reasoning in psychology and education (3rd ed.). New York: Wiley.

    Google Scholar 

  • Moskowitz, D. A., & Roloff, M. E. (2007a). The existence of a bug chasing subculture. Culture, Health & Sexuality, 9, 347–357.

    Article  Google Scholar 

  • Moskowitz, D. A., & Roloff, M. E. (2007b). The ultimate high: Sexual addiction and the bug chasing phenomenon. Sexual Addiction & Compulsivity, 14, 21–40.

    Article  Google Scholar 

  • O’Hara, S. (1997). Autopornography. New York: Haworth.

    Google Scholar 

  • Orange, D. M. (2002). High-risk behavior or high-risk systems? Discussion of Cheuvront’s ‘High-risk sexual behavior in the treatment of HIV-negative patients’. Journal of Gay & Lesbian Psychotherapy, 6, 45–50.

    Article  Google Scholar 

  • Parsons, J. T. (2005a). HIV positive gay and bisexual men. In S. C. Kalichman (Ed.), Positive prevention. Reducing HIV transmission among people living with HIV/AIDS (pp. 99–133). New York: Kluwer Academic/Plenum Publishers.

    Google Scholar 

  • Parsons, J. T. (2005b). Motivating the unmotivated: A treatment model for barebackers. Journal of Gay & Lesbian Psychotherapy, 9, 129–148.

    Article  Google Scholar 

  • Parsons, J. T., & Bimbi, D. S. (2007). Intentional unprotected anal intercourse among who have sex with men: Barebacking—from behavior to identity. AIDS and Behavior, 11, 277–287.

    Article  PubMed  Google Scholar 

  • Parsons, J. T., Schrimshaw, E. W., Wolitski, R. J., Halkitis, P. N., Purcell, D. W., Hoff, C. C., et al. (2005). Sexual harm reduction practices of HIV-seropositive gay and bisexual men: Serosorting, strategic positioning, and withdrawal before ejaculation. AIDS, 19(Suppl. 1), S13–S25.

    Article  PubMed  Google Scholar 

  • Race, K. D. (2003). Revaluation of risk among gay men. AIDS Education and Prevention, 15, 369–381.

    Article  PubMed  Google Scholar 

  • Rhodes, S. D. (2004). Hookups or health promotion? An exploratory study of a chat room- based HIV prevention intervention for men who have sex with men. AIDS Education and Prevention, 16, 315–327.

    Article  PubMed  Google Scholar 

  • Ridge, D. T. (2004). ‘It was an incredible thrill’: The social meanings and dynamics of younger gay men’s experiences of barebacking in Melbourne. Sexualities, 7, 259–279.

    Article  Google Scholar 

  • Riggs, D. W. (2006). ‘Serosameness’ or ‘serodifference’? Resisting polarized discourses of identity and rationality in the context of HIV. Sexualities, 9, 409–422.

    Article  Google Scholar 

  • Shernoff, M. (2004). Barebacking and challenges to therapeutic neutrality. Journal of Gay & Lesbian Social Services, 17(4), 59–68.

    Article  Google Scholar 

  • Shernoff, M. (2005). Without condoms: Unprotected sex, gay men and barebacking. New York: Routledge.

    Google Scholar 

  • Shernoff, M. (2006). Condomless sex: Gay men, barebacking, and harm reduction. Social Work, 51, 106–113.

    PubMed  Google Scholar 

  • Sorrell, J. M., & Redmand, G. M. (1995). Interviews in qualitative nursing research: Differing approaches for ethnographic and phenomenological studies. Journal of Advanced Nursing, 26, 1117–1122.

    Article  Google Scholar 

  • Suarez, T., & Miller, J. (2001). Negotiating risks in context: A perspective on unprotected anal intercourse and barebacking among men who have sex with men—Where do we go from here? Archives of Sexual Behavior, 30, 287–300.

    Article  PubMed  Google Scholar 

  • Taéron, C. (2003). Bareback: En quête de raisons et de sense [Bareback: A search for reason]. Le Journal de Sida, 155, 12–23.

    Google Scholar 

  • Tewksbury, R. (2003). Bareback sex and the quest for HIV: Assessing the relationship in Internet personal advertisements of men who have sex with men. Deviant Behavior, 24, 467–482.

    Article  Google Scholar 

  • Tewksbury, R. (2006). “Click here for HIV”: An analysis of Internet-based bug chasers and bug givers. Deviant Behavior, 27, 379–395.

    Article  Google Scholar 

  • Tomso, G. (2004). Bug chasing, barebacking, and the risks of care. Literature and Medicine, 23, 88–111.

    Article  PubMed  Google Scholar 

  • Wilton, L., Halkitis, P. N., English, G., & Roberson, M. (2005). An exploratory study of barebacking, club drug use, and meanings of sex in Black and Latino gay and bisexual men in the age of AIDS. Journal of Gay & Lesbian Psychotherapy, 9, 49–72.

    Article  Google Scholar 

  • Wolitski, R. J. (2005). The emergency of barebacking among gay and bisexual men in the United States: A public health perspective. Journal of Gay & Lesbian Psychotherapy, 9, 9–34.

    Article  Google Scholar 

  • Yep, G. A., Lovaas, K. E., & Pagonis, A. V. (2002). The case of riding ‘bareback’: Sexual practices and the paradoxes of identity in the era of AIDS. Journal of Homosexuality, 42, 1–14.

    Article  PubMed  Google Scholar 

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Acknowledgment

The author would like to express appreciation to Michael W. Ross, Ph.D., Dr. Med. Sc., for his valuable contributions to the article.

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  1. Norwegian Knowledge Center for the Health Services, Box 7004, St Olavs plass, 0130, Oslo, Norway

    Rigmor C. Berg

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Correspondence to Rigmor C. Berg.

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Berg, R.C. Barebacking: A Review of the Literature. Arch Sex Behav 38, 754–764 (2009). https://doi.org/10.1007/s10508-008-9462-6

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