Barebacking Identity Among HIV-positive Gay and Bisexual Men: Demographic, Psychological, and Behavioral Correlates

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Almost 20 years after the start of the HIV epidemic in the US, a significant number of gay and bisexual men continue to practice unsafe sex. As a result there has been an increase in the number of new HIV infections. The primary route of transmission is unprotected anal intercourse (barebacking).

The objective of the present study was to determine the correlates associated with barebacking identity among HIV-positive gay and bisexual men. To achieve this, researchers undertook an analysis of data from a randomized controlled intervention study of 1168 HIV-positive gay and bisexual men from New York City and San Francisco.

Participants were actively and passively recruited from mainstream gay venues, AIDS service organizations, and public and commercial sex environments. Participants completed a computerized quantitative questionnaire assessing their identity as a barebacker, sexual behavior, demographic factors, psychosocial states, perceptions of health risks, and substance use.

Results

· Men of color were less likely to identify themselves as barebackers.

· Men who did identify themselves as barebackers were slightly younger.

· They were more likely to miss a dose of medication; report drug use (non-injection and injection); exhibit higher levels of sexual compulsivity and lower personal responsibility for safer sex; and to report higher rates of unprotected insertive anal intercourse, unprotected receptive anal intercourse, and unprotected insertive oral intercourse with all partners, regardless of their HIV serostatus.

Based of these findings, the authors conclude, “Barebacking and its corresponding behaviors pose immediate public health risks for HIV-positive gay and bisexual men. Further work is needed to understand this phenomenon more fully in relation to the psychological, sociological, biomedical, and cultural realities.”

This research was funded by the Centers for Disease Control and Prevention through cooperative agreements with New Jersey City University and the University of California, San Francisco.

04/22/05

Reference
P N Halkitis and others. Barebacking identity among HIV-positive gay and bisexual men: demographic, psychological, and behavioral correlates. AIDS 19 (Supplement 1):S27-S35, April 2005.