The Bay Area Reporter - July 27, 2000
Terry Beswick

"Everybody is doing it," said Vince Gaither flatly.

What's "everybody" doing that has San Francisco's HIV and gay communities in a subdued state of soul-searching turmoil?

According to Gaither and others with intimate knowledge of the phenomenon, they're barebacking -- fucking guys, or getting fucked by guys without lubing up a condom and stretching it over the penis of their prospective top.

HIV-positive guys, like HIV Prevention Planning Council member Gaither, are doing it.

And, according to reliable sources in the gay community, HIV-negative guys are doing it.

What's more, guys are doing it with guys of different or unknown HIV serostatus.

While Gaither, and other HIV-positive barebackers like Stop AIDS Project staffer Keith Folger, say that they reserve their barebacking for other HIV-positive guys from whom they have obtained a verbal informed consent, others suggest that their avowedly principled practices may be more the exception than the rule.

As mentioned in last week's Bay Area Reporter, local gadfly activists from ACT UP/San Francisco and Queer Nation staged public "outings" of Gaither and Folger at two HIV prevention forums on July 13, circulating graphic photos the two had posted on a Web site, barebackcentral.net, a free site for men from around the country who want to "hook up" with other like-minded barebacking men.

The Web site, based in Atlanta, noted that it had been viewed by over a half million people.

On the rise?

Some observers suggest that barebacking is on the rise in San Francisco, and that gay men are shutting down -- growing immune to the "safer sex" messages delivered by the public health system and the prevention educators it funds. Several longtime activists and HIV-positive men who bareback say that city agencies have failed to grapple with the realities of sexual practices in the community today, leaving men who are, in fact, not using condoms to figure out for themselves how to reduce their risk of getting HIV, or passing it on to others.

"It's sad that at this point in history, we're actually perceiving sperm as a bad and evil thing. We're very much in a 'middle-ages' in that respect," commented Niq Shelbi, a title-holder in San Francisco's leather community and an openly HIV-positive bottom who also advertises on the barebackcentral.net Web site. "The topic of exchanging fluids has become so negatively impacted, that we've allowed the radical 'condom nazi's' to rule our private lives, snooping in on our sex-club interactions and attempting to pass laws that would make sex without condoms illegal."

"People do it because it feels good," observed Steven Gibson, program director at the Stop AIDS Project and Folger's supervisor. "Natural sex for both gays and straights is unprotected. We as humans, in order to protect ourselves from sexually transmitted diseases, have developed condoms."

Not a lot of research has been done on the taboo subject since POZ magazine published two barebacking exposes by the recently deceased New York activist Stephen Gendin and by University of California, San Francisco doctoral student Michael Scarce in February 1999.

But one recent study confirmed Gibson's common sense assertion. As part of the study report, "Thought Processes Associated with Unprotected Anal Intercourse in Gay Men, San Francisco 1997-1999," 124 men who were seeking to schedule an HIV antibody test were asked a few questions. All the men were HIV-negative as of their last antibody test, and admitted that they had unprotected anal sex with a man who was HIV-positive or of unknown HIV status within the last year. The study, released earlier this month at the international AIDS conference in Durban, South Africa, was authored by Jim Dilley, executive director of the UCSF's AIDS Health Project, and asked the guys to reflect on the last time they barebacked.

Dilley found that just prior to their last such experience, 76 percent of the men said the main reason they decided not to use a condom was because it "feels good."

When asked, a majority of the respondents also acknowledged that they felt it "was only human to slip up occasionally," and that they had resolved to "withdraw before ejaculation."

Other than loss of pleasure, the most strongly endorsed factors contributing to their decision to go for it, as cited by Dilley and colleagues with UCSF and DPH, included "fatalism, or leaving it to chance," "loss of control," and "inferring that the partner was not infected based on looks, speech, or behavior."

In conclusion, Dilley asserted that "supportive, non-judgmental counseling" sessions might help gay men to change their behavior.

Cat out of the bag

Several people interviewed by the B.A.R suggested, essentially, that the cat is out of the bag, and that while most barebacking aficionados are not talking about it publicly -- or even privately -- neither are public health experts attacking the problem in a thoughtful way. In fact, contrary to Dilley's conclusions, some suggest that most publicly-funded HIV prevention programs in San Francisco are inherently judgmental on the reality of unprotected anal sex, or simply fail to address it in public.

And sometimes prevention workers say, and do, something very different in private.

"I have a great fuck bud," volunteered Shelbi. "When I met him, he was wearing his foundation's T-shirt, and I said, after much heavy kissing, 'I don't think we're compatible. I'm a barebacker,' and pointed to his shirt. He'd also told me that he's an AIDS educator at this particular organization. He said, 'I don't necessarily practice what I preach.'"

It is not known how common the practice of barebacking is in San Francisco or in other parts of the country, although a recent report published in the New York Times suggested that in that city, gay men have reduced their levels of unsafe behaviors.

"There isn't a gay man in the world who doesn't have unprotected anal sex," asserted Folger.

In San Francisco, however, public health authorities are pointing to a number of indicators suggesting that the HIV infection rate is going up, and speculation runs rampant as to why that is the case.

UCSF Center for AIDS Prevention Studies Director Dr. Tom Coates, while noting that "the research has not yet been done," echoed the most commonly cited factors that are contributing to the likely increase in less safe sexual behavior, including the advent of new therapies, burnout among gay men who have grown tired of being vigilant about HIV, methamphetamine use, and others. But Coates, and a new multi-agency pilot project coordinated by DPH, puts the onus on HIV-positive gay men to stop further spread of the virus.

"If we look back to the early 1980s, it was the community that took the initiative," Coates said. "It's a challenge that I put out there. It's time to challenge people who have HIV and say, 'there's only one way this happens, and it's time to take responsibility.'"

The CDC-funded pilot projects, including a television commercial and print ads now being filmed entitled, "HIV Stops With Me," target HIV-positive men with their messages but do not approach the subject of barebacking specifically, according to multiple sources.

DPH and CAPS have often used the media to publicize their concerns about statistics indicating a rising rate of HIV and other sexually transmitted diseases in San Francisco. But, right or wrong, some in the community have perceived these messages as "fear-mongering" in an attempt to drum up fear as a means to change their behavior.

"Informed, consensual choice has become the new gay battle cry of those brave enough to overcome the unjustified scare tactics bombarding the media," stated Shelbi, San Francisco's Mr. Drummer. "Fear is a powerful tool."

It is widely acknowledged that barebacking is how most people in San Francisco get infected with HIV. Even schoolchildren are likely to be aware that condoms, when used properly, significantly reduce the chances of passing HIV, the virus that cause AIDS, and other STDs between partners.

And yet, while the current official estimated number of people who seroconvert each year in San Francisco stands at 500, this estimate is planned for an update in September by a select DPH/UCSF panel, who are considering a preliminary estimate of 900.

Some local activists, including Michael Petrelis and David Pasquarelli who have advocated reopening gay bathhouses in the city and who performed the recent barebacker "outings," have called for Gaither's and Folger's resignations from their posts, a suggestion that their supervisors call self-defeating. Gaither, also known as Sister Mary Mae Himm, serves as a volunteer member of the HPPC, a panel appointed by the director of public health to prioritize the city's HIV prevention planning, while Folger directs a Stop AIDS Project series of prevention forums for HIV-positive men, a component of the CDC demonstration program in the city.

"They are calling for their resignation, and I really think the whole purpose of HIV prevention planning is to get all the segments of the community together to make safer choices," said Steven Tierney, who is co-chair of the HPPC and director of HIV prevention for DPH.

While noting that "the only safe sex guideline is abstinence," Folger said that this is "not realistic." He, Gaither, and other experts are calling for a form of HIV prevention commonly practiced outside the United States called "harm reduction."

In the context of HIV prevention, "harm reduction," a model more commonly employed here for drug addiction treatment as an alternative to abstinence, suggests that two consenting adults who are well-informed about the known risks of various sex practices, come to a mutual agreement of what practices they will engage in.

It also suggests that public health experts educate barebackers about how they can reduce their risk of acquiring HIV, or of passing it to their partner, if they are, in fact, going to be barebacking anyway.

But Tierney could not point to any existing or planned DPH-funded program designed to do that. Neither could the AIDS Health Project's Dilley, and neither could the San Francisco AIDS Foundation, other than "Assumptions," an ad and poster campaign that implies you cannot assume what your sex partner's status is.

Meanwhile, people who choose to bareback, whether they meet over the Internet, in Berkeley's well-regulated bathhouse, or in San Francisco's several popular sex clubs, are getting streetwise, passing information as well as rumors back and forth on how to prevent infections, as well as re-infections.
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