Presented by invitation at the Annual General Meeting of AIDS Vancouver Island in Victoria on July 15, 2000.

Barebacking ­ Rational Choice?

by Michael Botnick

Thank you for that inspiring introduction. I think that with those credentials, I should hire me right now!

When Mark called me and told me about your meeting, and its theme, I began to think about some emerging issues in the field of HIV and AIDS ­ prevention, statistics, drug therapies, testing and so on. And to be sure, there are many new developments in these fields. But the more I thought about it, the more I realized that what I wanted to talk about is people ­ gay men in particular, and why many of us have chosen to 'follow another drummer', often disregarding the "100% safe, 100%' of the time" messages that have been so popular with Health departments, AIDS service organizations and the media.

Deliberate risk behaviour, and that's what unprotected sex really is, is a social action. It has particular meanings for different people, and it happens in a social environment ­ not in a laboratory, a statistic or an advertisement.

Late last year, as part of a larger undertaking, I interviewed 18 members of the Vanguard project, and today I would like to illustrate why so-called risk behaviour is THE EMERGING ISSUE, in part using their words. I say 'so-called risk' because I want to distinguish between the "oops's" ­ 'broken condoms', 'had too much to drink', 'was stoned' type of reasons for unprotected sex, and the deliberate, calculated, often negotiated decisions not to use condoms.

First of all, it's very important to emphasise that one of the most consistent findings of behavioural research is that unprotected sex occurs far more frequently between 'regular' partners than it does between 'casual' partners. In other words, unprotected sex takes on a kaleidoscope of meanings when one considers the variety of types of relationships that the term 'regular partners' conjures up.

There are a couple of themes that will become self evident as I speak ­ rational choice and trust. Time was, and I am ashamed to admit that I was in part responsible for this, that we told gay men to automatically assume EVERYONE was HIV+, and to use condoms all of the time. What many of us now realize is that what we were doing in essence, was being sex phobic ­ scaring people into both reducing their number of partners, and treating all gay men as carriers of contagion. Well, I'm past that, and I hope that some of you here are too!

In the interviews, the issue of trust came up very frequently. When I asked one of the participants, lets call him Max, what would change his mind about using condoms all of the time, he replied:

"That's always a good debate, over coffee. Would you at some point - if you had a long-term partner, would you stop using condoms? Part of me says yes, part of me says no. I don't know if I could ever come to a point and just stop using them. Even in a "committed relationship" because if I watch the "committed relationships" around me - although I do have friends that within their partnership they don't use condoms, and they freelance a little on the side and they have strict rules so - I think a large portion - if it comes to decisions - trust in the person that you're gonna be sharing it with."

Harley, another participant, was suitably terrified about the risk factors. His decisions were based on fear. He was in a relationship that ended, and then picked up again. When I asked him about what percentage of the time he felt that he had unsafe sex, in the traditional sense of 'safe sex' he replied:

"Like condoms? Yes, because the trust piece is tricky. Because with the off and on thing with the guy there were times when we didn't use condoms and we probably should have, because other partners had been involved in between. But I just know how phobic he is about AIDS and so on, and he knows how phobic I am."

To decide it with a partner is based on a pretty complex assessment of criteria over a long period of time. Like there's a time-frame that has to happen where I really come to understand and know the person well. I look at objective criteria. I know that sounds ridiculous but I look at their professional life, I look at how they conduct themselves financially. I look at how far back their friendships go and look at what they put into the community. I look at what I understand of them and heard them tell other people. How internally consistent that is with what I've experienced happening with them. I look for inconsistencies. And once those pieces are decided, we have a lot of discussion about monogamy - if it is important to each of us the same way. Why either one of us would want to be monogamous - because I don't accept the sort of Christian heterosexual model reason why.

So the decision whether or not to use condoms, in this case, is based on trust ­ but trust that that this is a 'good person', not necessarily a monogamous person. There is an implication that sex outside of the relationship is ok, provided that it is 'safer sex', and as Harley suggests later on in the interview, there is some form of disclosure that sex outside of the relationship took place, and that it was 'safe'.

This relationship eventually broke up, and with it, Harley's resolve. One of the emerging issues, that I am certain many people 'in the field' intrinsically know, is that people are fed up with AIDS education, being told what to do and what not to do. The safe sex message has been blunted by both over-use and over-kill. As Harley states:

"Like anybody else ­ I hate sex with condoms. Since then, I have had unprotected sex and it was very risky. I didn't wait as long as before when I knew the person. But I still felt pretty grounded in finding out about their feelings towards me, their feelings about themselves and so on. I mean, I'm not gonna - I wasn't about to jeopardize my - how do I say this - if this person doesn't care about themselves, doesn't care about the world that's around them, then we've got some conflicting morals right there. And I'm not sure if I want to be on the train ride to Hell with them. Because there's some people that are out there that really want to hurt themselves and will do it whatever way they can. And I can't go there. So - yes, as of late, there have been times - yes - where I didn't wait as long. It's kinda like when you first come out - especially in Toronto, it was huge. It was like educate, educate, educate. So I just HUNG UP on getting educated and hit on all sides by all this education - pamphlets, materials, do this, do that, don't do this, and so on."

A third example is Martin. He doesn't like condoms. His definition of unsafe also involves a relationship model like Harley's, only this time the issue is not so much empirical evidence, as much as it is subjective: I asked him:

"The sex that you've been having in last six months, would you define that as safe sex or not safe sex or somewhere in between?"

His answer?

"Somewhere in between. Sometimes I've been safe, and sometimes I haven't. I define unsafe is when you use penetration without a condom. Unsafe is having sex with somebody YOU DON'T KNOW and you're not using condoms, at all. I find safe is when you are using condoms, and I find safe WHEN I FEEL SAFE not using condoms with friends. I've had a few sexual experiences with close friends lately, which have been pretty good. I think that's one of the reasons why my sex life is better. A few long-time friends and I started having sexual relations very casually, and it's very comfortable, and it's nice and there are no expectations. We're still friends like we always have been. We hang out for reasons other than sex. And sex is not a condition for our friendship. But, it's kind of nice ­ we have a certain freeness with a few people, if we ever feel like were not getting enough, or we're just in the mood for sex and were both around we can do it, and there's no problems or hang-ups about it. It's kind of nice. And it's safe. I feel safe."

"What percentage of the time, would you say, would you use condoms for receptive anal sex?"

"About 80 percent of the time."

"What about insertive anal sex?"

"More like 40."

These are but a few examples, from their own mouths, as to why gay men are having unprotected sex. It's not based on rebellion, nor is it a devil-may-care attitude. There is a particular meaning in their choices of sex partners and sexual behaviours.

To some, it may sound totally irrational, mindless and misguided. Others may want to applaud their honesty, frankness and independence. Regardless of what position you personally may take, THIS IS THE EMERGING ISSUE ­ there is a process going on that involves rule-making that defies traditional Knowledge, Attitude, Behaviour education, epidemiology or number crunching. The only way to get at this information is to talk to the people involved, and really listen to what they have to say.

I would like to turn, for a brief moment to how I see this issue. Any of you who have either heard Eric Rofes talk, or have read one of his books, will know that he is a strong advocate for sexual choice, sexual liberation and bringing together the whole field of gay mens' health ­ physical, mental and spiritual. He and I must have been twins in a previous life, because, while there are some issues on which we disagree, we are of the same mind when it comes down to the basics. So, if this sounds like a Rofes Rant, you now know why.

I appreciate that to listen to a gay man talk about getting fucked and taking semen up his butt, without the usual expressions of horror, regret, or "I've learned my lesson!" is more than many people can stand. However, some of us are trying to break through the silence and expose the lie that was the basis upon which so many people defined their public identities as "respectable" gay men.

By standing here as an example of a sexual gay man who appears before the public unapologetically as neither a member of a monogamous gay couple nor a de-sexed celibate sacrificing my entire personal life to the demands of community work, I have achieved a 'bad-boy' status among those who struggle to maintain a community self-image as the 'best little boys in the world'. And, perhaps most importantly, I, and many others are trying to create a space for an alternative voice within gay male communities, a critical voice of resistance to the demonization of gay men's sex. During an era when many forces discourage people from speaking out, as one of those who believes in the power of the erotic as a central component of social change, I believe that we have begun to find a way to assert our vision and our values into the community dialogue.

I believe the use of shame, terror, and punishment as central tools of disease prevention is a key cause of men's alienation from their bodies and desires, from their abilities to make rational choices. I have no doubt that our work will contribute to improving the sexual health-and the mental and spiritual health - of gay men.

A major challenge to this work is the difficulty in conveying messages about sexual liberation to a hostile media and a public-which increasingly includes a queer public-which hears of our work and beliefs and thinks, "WHAT PLANET ARE THEY ON?" How do we articulate our beliefs that promiscuity may be as moral as monogamy, that the right to choose an open relationship may be as ethical as choosing celibacy? I don't know, but I do know that by speaking out, first steps have been taken.

I want to close this talk by suggesting a direction for organizing and planning over the next year. First, creating a coalition of all of the different groups facing the threat of a moral panic over sex seems fundamental to me. We must all, of course, continue our internal efforts focused on gay men's communities, but we need to link up with allies ­ by organizing sex workers, pornographers, sadomasochists, and others, as well as those working for sexual and reproductive freedom for women.

I also want to encourage you to work over the next year to continue to highlight prominently the linkage between sexual liberation, public health, and social change. Over the past 15 years, I've worked on a range of gay men's health issues. I've written a book on gay people and our communities, and am halfway through another on risk, choice and sex. I've researched and written papers on suicide, racism, and rational choice, directed a multi-purpose gay and lesbian center, led AIDS organizing efforts, and founded programs for gay youth. In every case, the repression of sexuality through guilt, shame, moralizing, and terror has been a major barrier to health promotion.

There is no need to create a false opposition between health and freedom, sex and the spirit. Nor is there any need to pretend that sexual cultures do not face their own specific health challenges. Yet to allow those who advocate for the displacement of sex from a central position in gay cultures, to represent themselves as health-minded and us as disease-promoting, is not only wrong, it is dangerous. Let our work continue to integrate a commitment to democratic freedoms, social change, and sexual health.

I am reminded of the person who invests all of his capital in insurance, denying himself any earthly pleasure, but guaranteeing that in the event of a catastrophic disaster, he will be totally covered. This seems to me to be a Faustian bargain, one that I would most assuredly not rationally make. I encourage you not to make it either.

Thank you for having me here today.