A Deadly Dance: As AIDS Cases Decline Sharply, Some Gay Men Are Returning to Unsafe Sex. They Call It Barebacking
Peyser, Marc, Newsweek
As AIDS cases decline sharply, some gay men are returning to unsafe sex. They call it barebacking.
JOSEPH HILBURN GOES FOR AN HIV test every six months and reads everything he can find about AIDS. He certainly doesn't want to get it. Yet that doesn't stop him from having unsafe sex two or three times a week--"more, if I'm lucky," he says. Though he's been doing it for years, Hilburn, 32, says he's recently noticed a change: it's much easier to find men willing to have unprotected sex. "I've been to clubs where there's sex all over the place and they have a little fruit bowl full of condoms and it's covered with dust," says Hilburn, a computer analyst in a New York hospital. "The taboo has worn off."
Both gays and straights have struggled with the inconvenience of safe sex since the AIDS epidemic made condoms necessary more than a decade ago. But as AIDS deaths plummeted 23 percent in the last year due in large part to new drugs known as protease inhibitors (chart), a small but growing minority of gay men have begun seeking out unsafe sex again. Because of the months-long HIV incubation period, it's too early to tell if this new attitude will reverse the declines in infection rates among homosexuals. But the signs are ominous. A small study conducted by doctors at the University of California, San Francisco, and published last month in The New England Journal of Medicine found that 15 percent of the men surveyed had already engaged in higher-risk sex because they're less concerned about AIDS. Scores of America Online subscribers have adopted a phrase--bareback sex--and included it in their biographic profiles as a way to meet like-minded men. Scariest of all: a tiny but visible group of HIV-negative men are actually looking to get infected. "The potential to roll back the last decade's worth of advances is enormous," says Seth Kalichman, a professor at Georgia State University. "People are gambling with their lives."
Barebacking got a big boost in the last few months from what has come to be called the "morning after" pill. The treatment, which really requires taking a potent combination of AIDS drugs for 28 days, may prevent HIV from taking root if taken within a few days of exposure to the virus. A six-year study of 710 health-care workers accidentally stuck by AIDS-infected needles found that the therapy reduced the odds of infection by 79 percent. Some private doctors have already begun prescribing the post-exposure drugs, and the Centers for Disease Control is considering recommending them for gay men, rape victims and IV drug users. Next month the City of San Francisco will begin a pilot post-exposure drug and counseling program. The morning-after regimen, though promising, is making some AIDS warriors nervous--and for good reason. Kalichman found that 26 percent of 327 HIV-negative men he surveyed this summer had already planned to use the post-exposure drugs, even though no one knows if they'll work outside the strict confines of a hospital. "If it doesn't work," says Robert Janssen, deputy director of HIV/AIDS prevention at CDC, "you have a person infected with lethal virus for life."
The barebacking world is most visible in cyberspace. When Brian (not his real name) stumbled into a barebacking chat room, the guys there told him hardly anyone practices safe sex now that HIV is as easy to treat as the flu. He started having sex without condoms and never gave AIDS a second thought--until two months ago, when he tagged along with a friend who was getting tested for HIV. …