There's no question that bareback sex (anal penetration without a condom) is on the rise among gay men. The act is inherently risky. Even if two people are HIV negative, and in a relationship that is ostensibly monogamous, there is no guarantee one or the other partner will not stray, sero-convert and bring home the infection. Clearly, if anal penetration is part of someone's repertoire, condoms are the best way to go.
The problem as I see it is that HIV/AIDS prevention educators have not done the best job they could have done in this arena. I do not fault their earnestness, their dedication (usually involving long, unpaid or underpaid hours), nor the intent of their efforts. I came out in the early 90s, and I remember the intensity of the education efforts, and even did some volunteer work with an organization in a major southern city. I believe in the effort to prevent the spread of HIV/AIDS, and I have tremendous love and respect for the lives and work of prevention educators. But I find two ways I think they should have approached the topic differently.
First, they should have been honest from the beginning and said that condoms really, really suck. They decrease sensitivity dramatically, especially if the wearer is circumcised. If one has experienced bare sex, wearing a condom feels almost as if one's partner in sex might as well be in another room. This especially becomes an issue when the lack of sensation leads to the loss of erection. The bottom line is that a lot of men cannot top with a condom on. It becomes physically impossible for them, unless they choose to take expensive erection-enhancement pills. But even those able to sustain erections won't feel nearly as much with a condom on. Educators should have been honest and up front about this aspect from the very beginning. They should have made a point of saying, "Look it's too bad, but anal penetration sex acts are just going to be a lot more work and a lot less fun so long as AIDS is a possibility. Still it is the mature, responsible and compassionate thing to always wear a condom when penetrating a partner." Had they been honest, instead of all these campaigns which tried to either minimize the difference, or even eroticize condoms, I think their campaigns would've had more traction.
Second, they should have more actively celebrated the other ways of having sex than anal penetration. I think as a legacy of the "gay 70s" anal penetration somehow became the sine qua non of gay sex, and other forms of intimacy/sexual activity were regarded as not being "real sex". This is a shame. Let's face it, hands wrapped around a penis are more nimble and dextrous than an anal sphincter wrapped around a penis. Mutual masturbation is a fantastic, enjoyable and very intimate form of sexual activity. It should have been celebrated, promoted and, hell, even sanctified as the best possible gay sex. Second to the brain itself, one's hands are among one's greatest, most versatile sex organs. Hands and the digits on them, can do many wonderful things. (For that matter, one's digits can be used for prostate stimulation if a "bottom" requires it.) Educators should have taken the opportunity to redirect gay men's attention toward all the wonderful things they could do and the great variety of sexual possibilities available to them, instead of emphasizing only the mechanics of anal sex with a condom.
I think there was a missed opportunity in HIV/AIDS prevention education, and I think that barebacking was an understandable response to this failure to deal honestly with the facts of anal sex and condoms. Unfortunately, young men will die because of this.
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