health issue  

safe-sex
urn-out:

There are men out there who want to be
infected with HIV, and among other names,
they’re called “bug chasers.”

BY Jusrm BARTON-CAPLIN

ecent data from the

Centers for Disease

Control (CDC) and some
state Health Departments high-
light increases in risky sexual
behaviors in men who have sex
with men (MSM), particularly in
urban areas. These increases in
risky sex have coincided with
rises in sexually transmitted
infections (STIs) like syphillis,
gonorrhea, and chlamydia, and
have coincided with rises in esti-
mated HIV infection rates (CDC,
Oct 2000).

It seems that as we start
into a third decade of the ,
HIV/AIDS epidemic, gay popula-
tions have given up on or are
ignoring safer sex practices. In a
time when most people recognize
the risks around unprotected sex
and have been inundated with
HIV prevention information, the
choice to engage in risky sexual
behaviors is often an informed
one. The reasons for such a deci-
sion are varied and multi-layered,
including optimism about new
drug therapies, the desire for
increased intimacy with a sex
partner, the search for intense
sensation, spontaneity, a sense of
denial, fatalism (we all die any-
way), low-self esteem, apathy,
thrill-seeking, wanting to belong
to a particular sub-culture, and
even the desire to be HIV-posi-
tive.

To some of us, these
rationales may seem ridiculous or
even abhorrent, but to the men
engaging in barebacking, or
unprotected anal intercourse, they
are real and motivating. As an
HIV/AIDS educator, I must be
aware of these reasons and try to
understand while trying to ade-
quately address them. However, I
must also recognize that, for
some men, this is a life choice
and I must respect their decision.
As men having sex with men, we
need to be aware of these issues
and check in with ourselves and
with our sexual partners.

With the advent of mul-
tiple drug therapies, which now
include protease- and reverse

transcriptase-inhibitors and other
anti-viral medications aimed at

- slowing down HIV production,

there seems to be the myth that
HIV-positive people live “normal,
healthy lives.” While it is true
that many people on HIV anti-
virals live much longer today
than people on therapy a decade

   

ago, their quality of life is still
heavily impacted by both their
HIV infection and the side effects
of their treatment. These “mira-
cle” drugs can induce intense
bouts of nausea, prolonged peri-
ods of diarrhea, noticeable body
wasting,-increased deposits of fat
in the abdominal areas, and even’
chronic fatigue. San Francisco
officials pulled HIV drug ads
from newspapers and television
because they showed only athlet-
ic and totally healthy individuals.
SF decided that such ads did not
adequately portray the symptoms
and side-effects of being on an
HIV drug regimen and that they
thus promoted the myth that one
could be infected with HIV and
be completely healthy. It was
considered misleading at best, a
form of fraudulent advertising at
worst.

For most people, sex is a
pleasurable experience. So, when
we start talking about safer sex

 

 

and condoms and dental dams,
we always hear about the
decreased sensitivity and a lack
of intimacy or spontaneity. While
not wanting to minimize people’s
concerns, I must mention the
“Sex Positive” movement. That’s
where you talk about alternatives
to intercourse, discuss sexual out-
ercourse (where penetration does
not happen), bring up tantric sex,

 

of HIV/AIDS, thinking that it is
isolated to urban centers or to
sub-Saharan Africa. HIV/AIDS is
a global issue — an epidemic with
roots in rural areas. If you live in
an area with other human beings,
you live in an area with HIV. It
can infect anyone engaging in
risky behaviors.

In a similar vein, there
are-those people who view the
HIV epidemic as a function of
fate. They view their lives fatalis-
tically as pre-determined. There
is nothing that they can do that

 

will change their life-course.
We also have within our

communities gay men dealing
with low self-esteem. Often,
these men don’t care enough
about themselves to worry about
their health or about even protect-
ing their lives. Thus, when pre-
sented with a sexual opportunity,
safe sex is not the first thing that
pops into mind. Apathy has the
same effects on safe sex. There
are prevention programs, such as
Mpowerment, that aim to
improve gay men’s sense of self-
worth and control over their own
lives. Studies have shown them to
be effective in reducing HIV
transmission rates.

Finally, some men
choose to bareback either because
they are already positive and
think that they don’t need to

If you live in an area with
other human beings, you live
in an area with HIV. It can
infect anyone engaging in

risky behavior.

and brainstorm how to make
latex sexy. Be creative! Allow sex
to be an extension of your cre-
ativity! There are preliminary
studies that show that the Sex

_ Positive approach has had benefi-

cial effects and may help reduce
STI and HIV infection rates, par-
ticularly among men who have

_sex with men (MSM).

Some people choose to
bareback because they are in
denial about the risks of HIV
infection: “It won’t happen to
ME.” Living in Vermont, we
often lose touch with the realities

worry about HIV, or because they
want to be positive too. HI‘/-posi-
tive people are still at risk for
HIV. The virus mutates, or
changes, very quickly. If you are
HIV-positive and are having
unprotected sex with someone
else who is also HIV-positive,
then you may re-infect yourself
with a new strain, or different
version, of HIV. Sometimes this
new straincan be more virulent
(and make you sicker faster) or it
can be drug resistant (and thus
reduce the available drug
options).

There are men out there
who want to be infected with
HIV, and among other names,
they’re called bug chasers. The
motivations for wanting to be
infected may include guilt, thrill-
seeking, not wanting to worry

about safe sex any more, wanting

to belong to a community, and
even getting access to disability
checks and other financial servic-
es available to HIV-positive indi-
viduals.

In some areas of the
country, barebackers have united
and even identify as a group.
There are barebacking parties:
with all positive men; with all
negative men; with both positive
and negative men (known as con-
version parties); and even with
both positive and negative men
where the negative men take their
chances that they will become

infected (known as Russian

Roulette parties; usually the par-
ticipants don’t know who is posi-
tive or negative). Obviously, cur-
rent prevention practices are
becoming ineffective and are not
adequately reaching all MSM
populations.

Discussions of the body
fluids that transmit HIV (blood,

semen, vaginal fluid, and breast‘: 

milk), the importance of using
condoms or dental dams, and
other basic HIV prevention infor-
mation just aren’t cutting it any
more. The need now is for the
data package to be expanded and
combined with information on
risk reduction. In other words, if
MSM are going to engage in
barebacking and other risky sexu-
al behaviors, then how can they
reduce the risk of HIV transmis-
sion? Has there been a culture
shift that now demands a shift in

 

prevention efforts? What mes-
sages do we send out so as not to
sound contradictory? These are
the questions facing MSM pro-
grams focusing on HIV
Prevention. As individuals, we
need to consider the options and
decide what is appropriate for
ourselves and decide how to cope .
with any consequences. Here are .
the choices: becoming HIV-posi-
tive or using condoms. V

Justin Barton-Caplin is an
HIV/AIDS Educator who lives in
Montpelier