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From a healthcare perspective, there is an underlying assumption that most gay and bisexual men do not intentionally seek to have unprotected anal sex. This paper presents the results of a qualitative investigation conducted in three Canadian gay bathhouses regarding unprotected anal sex among men. It is our contention that much epidemiological research, though helpful, obfuscates essential factors in the practice of bareback sex. Consequently, the paper addresses two themes: the identification from the participants' perspective of the risk factors involved in the practice of bareback sex and the identification of specific risk-reduction strategies used by barebackers. Our research results indicate that the majority of the participants were informed about health risks and took steps to avoid harmful practices even when engaging in high-risk sexual activities. Many participants, regardless of their HIV status, used risk-reduction strategies because the majority wanted to protect both their partners and themselves.
Keywords: bareback sex, masculinity, public health, qualitative research, risk
For the past few years, Internet access has facilitated casual and anonymous sexual encounters by increasing initial contacts between potential partners through the use of chat rooms and virtual communities. In Canada, however, although the Internet is considered an easy way for locating sexual partners, bathhouses remain the most popular and convenient way venues for men who have sex with men to meet (Ross, Tikkeanen, & Mansson, 2000; Somlai, Kalichman, & Bagnali, 2001). Bathhouses enhance desire and promote sexual diversity. Within their milieu, voluntary unprotected anal intercourse, commonly referred to as "bareback sex" is one of the choices available. The term bareback sex derives from the expression bareback riding (that is, riding a horse without a saddle). The usage acquired popularity about a decade ago (Scarce, 1999) and refers to a sexual practice in which condom use is explicitly and consciously eschewed during anal intercourse.
Although unsafe sex has been identified and reported since the beginning of the HIV epidemic, the general assumption is that most gay and bisexual men do not intentionally seek to have unprotected anal sex. We believe that this conclusion obfuscates essential components powering the practice of bareback sex and that this understanding of unsafe sexual practices is superficial because it does not recognize several determining sociocultural and psychological factors (Holmes & Warner, 2005).