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Inner contradictions among men who bareback.

Timothy Frasca1, Ana Ventuneac, Ivan Balan

  • 1Columbia University, New York, New York 10032, USA. frascat@nyspi.columbia.edu

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Gay and bisexual men engaging in barebacking (unprotected anal intercourse) use flawed HIV avoidance strategies. Cognitive justifications like self-justification and invincibility beliefs enable continued risky behavior, undermining prevention messages.

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Area of Science:

  • Public Health
  • Behavioral Science
  • Sociology

Background:

  • Barebacking, or intentional unprotected anal intercourse, gained visibility in the 1990s.
  • It signifies a shift in condom use acceptance among some gay and bisexual men.
  • This practice involves specific circumstances where HIV transmission is a risk.

Purpose of the Study:

  • To explore HIV risk avoidance strategies used by men who practice barebacking.
  • To understand the psychological mechanisms men employ to reconcile barebacking with HIV prevention.
  • To assess the impact of current prevention messages on this population.

Main Methods:

  • Exploratory study involving interviews with men who met partners online and reported barebacking.
  • Qualitative analysis of participants' self-reported strategies and psychological justifications.
  • Examination of cognitive dissonance and coping mechanisms.

Main Results:

  • Participants employed numerous strategies to avoid HIV infection instead of universal condom use.
  • Many acknowledged uneasiness with the inadequacy of their chosen strategies.
  • Cognitive strategies such as self-justification, compartmentalization, and invincibility beliefs were used to continue barebacking.

Conclusions:

  • Cognitive-based HIV prevention messages may inadvertently reinforce inadequate strategies for disease avoidance in this population.
  • Understanding these psychological mechanisms is crucial for developing effective public health interventions.
  • Further research is needed to address the dissonance between sexual practices and the desire to remain HIV-free.