A British survey of men who have sex with men revealed that 65% didn’t use condoms the last time they had anal sex, and more than a quarter consider their sex lives generally “risky.”
The UK charity Gay Men Fight AIDS (GMFA) asked 523 gay and bi men about their sexual habits—of the respondents who eschewed condoms, 14% said they barebacked because they and/or their partner was HIV-positive but undetectable. Only 8% said one or both of them were on PrEP. (England’s National Health Service only approved PrEP starting next month.)
While 32% of respondents said they were confident their partner was HIV-negative when they barebacked, just 11% admitted they really didn’t think about the risks in the moment.
“I slept with a couple of friends on the same night, both times without condoms,” says Tom, 19. “They had previously slept together, and both of them have slept with lots of other people.”
Rudy, 35, told GMFA that, since opening up his relationship, he’s taken more risks with his health.
“It’s usually with unplanned hook-ups, and we’re less likely to discuss our sexual health at a club or in a park.”
One 36-year-old respondent said he uses PrEP as an event-based dosing because he can’t afford it every month. “I [still] have some spontaneous encounters without PrEP and without condoms. I’m bottom and I know this is super-high risk, so every time I do this I’m putting myself at risk.”
In the heat of the moment, the risk can feel far-off. Other times, though, it stares you right in the face.
“I barebacked a guy without having a convo about sexual health beforehand,’ revealed Sam, 31. “The second time I met him, I noticed pill bottles on his nightstand so I made up an excuse, left and confronted him about them later. He apologized, admitted to being positive, and was just getting back on meds to keep it under control.” Sam took a recent-exposure test and found a doctor to put him on PrEP as soon as the results came back.
Of course, unprotected sex exposes partners to other STIs besides HIV, including gonorrhea, syphilis, and chlamydia.
“We all measure risk differently,” says David Stuart, a social worker who addresses substance abuse and chemsex in his work. “Some only associate risk with HIV—others consider all STIs to be a potential risk. For others, risk is measured by rejection for not being sexy enough, fit enough or interesting enough.”
Stuart says risk is not neccesarily a bad thing, “just something we need to negotiate.”
Almost all of us wish sex could be more carefree, says GMFA’s Ian Howley. But the fact is gay men are disproportionately affected by STIs, and hook-up culture doesn’t lend itself to frank conversation.
And navigating safer sex is a lot more complicated in 2017 than it was 20 years ago, when the only options were condoms or abstinence.
“The advancement of treatment, the fact that gay men who are on HIV treatment and have an undetectable viral load can’t pass on HIV, added to the increased number of gay men who are taking PrEP, means that gone are the days when sexual health education was just about telling people to use condoms,” says Howley. “We now must do more to increase gay men’s knowledge about all the options open to them.”