IN Toronto magazine

“I am seeing more and more guys preferring bareback sex. Why do you think this is?”

Barebacking, having sex without condoms, seems more openly discussed (and to some, more acceptable) than decades ago. Expert opinion however has not changed: HIV is still easily transmitted this way and is not curable. (Also you need to worry about getting gonorrhea, warts, chlamydia and syphilis.)

Many HIV-positive persons are choosing to have unprotected sex with other positive partners. This is still thought by many experts to have its own risks and should be discussed with your own healthcare provider. In the context of true monogamy between two negative partners you often see condoms fall to the wayside. However the amount of trust involved in this is huge — to be 100 percent safe you should trust no-one, including your boyfriend.

More worrying is HIV-negative casual partners going bare. You’re gambling when you bareback, especially with strangers. A 2002 study in San Francisco reported 57 percent of HIV-positive barebackers were willing to have unprotected sex with someone even if they were HIV-negative. Other studies further show HIV-positive men do not always disclose their status to negative partners. And finally, many men live with HIV and do not even know their status and bareback not knowing they are putting others at risk.

Many HIV-negative people are aware you can catch HIV through unprotected sex but are choosing to have unprotected sex anyway. Why that is remains a bit of a mystery and numerous theories abound.

“Condom fatigue” is one, meaning that guys are just tired of hearing that they should use condoms, find them a nuisance and would rather take the risk of contracting HIV.

Others, including myself, feel that a strong motivator for unsafe sex is that gay men no longer fear getting HIV. In the ’80s during the epidemic there was no good treatment and the death rate was high. People were terrified. Now we see smiling, happy, healthy-looking people in HIV drug ads and rarely hear stories of our positive friends dying from the disease. Why put on a condom when you can have sex that feels good and if you catch it, just take the meds like you would for diabetes or high blood pressure?

I find this train of thought to be most terrifying of all. These people are missing the point: Yes, you live longer and yes, there are good treatments that extend your life (perhaps even a “normal” lifespan) but they are expensive, require frequent doctor and hospital visits with repeated blood tests and, on top of this, you have to deal with potential horrible side-effects and large pharmacy bills. Not to mention the bother of taking medications up to four times a day. Those picturesque “life is perfect” ad campaigns don’t talk about the other problems frequently associated with HIV like chronic pain and fatigue, increased cancer risk and susceptibility to infection (to mention a few).

So, to sum up: Why? We don’t know. Should you? No. Confused? Talk to your healthcare provider.