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This abstract was
presented orally at the 11th Annual Canadian Conference on HIV/AIDS Research in
Winnipeg in April 2002.
Sex, intimacy and power:
The lived experiences of young gay men (YGM) in the context of
rising HIV infections in Vancouver
Arn J. Schilder,
Chris Buchner, Mary Lou Miller, Steve Martindale, Martin T. Schechter,
Michael V. O'Shaughnessy, Robert S. Hogg, Patricia Spittal
The Vanguard Project, BC Centre for Excellence
in HIV/AIDS, St. Paul's Hospital, Vancouver, BC.
BACKGROUND:
Recent seroconversion data indicate that regular and significant
relationships are potent predictors for HIV infection. However,
after 15 years of research few studies address the intimate/affective
lives of young gay men (YGM). Even less is understood regarding
the power dynamics that characterize YGM's intimate sexual lives.
OBJECTIVES:
To better understand the issue of rising HIV incidence in a
prospective study of YGM, it is necessary to understand the dynamics
of men's intimate sexual lives which place them at increased risk
for HIV infection.
METHOD:
Participants were recruited from the Vanguard Project, for
which these data were collected through 104 in-depth interviews
with 26 HIV-positive and HIV-negative YGM. These ethnographic
data were managed through NU*DIST software. Themes investigated
include family history, experiences with physical and sexual violence,
intimate relationships and HIV-related vulnerabilities.
RESULTS:
Results indicate that despite early heterosexual conditioning,
monogamy is an elusive concept in YGM's sexual lives. Gay men's
relationships can be characterized by the term serial and
non-serial gay polyandry. Regular and sero-discordant coupling
occurs within a polyandrous cultural context wherein multiple
relationships are influenced by various constructs of power and
status. YGM's beliefs about power are intricately tied to meanings
imbued in both penetrative and receptive roles in anal intercourse
known as topping and bottoming. Men who socially
identify as "bottoms" relearn to use their bodies and
minds. To facilitate bottoming, drug use including nitrite
inhalants and alcohol is a means to disinhibit or disengage;
exacerbating further higher risks associated with unprotected
receptive anal sex.
CONCLUSIONS:
YGM's experiences with risk are landscaped by inequitable power
relationships. Cultural identities tied to topping and
bottoming are gender and power constructs that must be better
understood by HIV interventionists.
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