Can Unprotected Anal Sex Ever Be Safe?

Outward
Expanding the LGBTQ Conversation
Dec. 2 2013 9:30 AM

Is Unprotected Anal Sex Ever OK?

Bareback rider from Australia.
A competitor in the bareback bronc-riding competition in Australia's 2013 National Rodeo Finals.

Photo by Matt Roberts/Getty Images

Last Wednesday, the CDC published a report noting that barebacking, or unprotected anal sex between men, is on the rise, increasing almost 20 percent between 2005 and 2011. The news prompted a concerned outcry from public-health experts and a dismayed finger wagging from veterans of the AIDS crisis, who warn of “a new AIDS epidemic.” (Who knew the old one was over?) These responses are understandable—but their alarmist tone is unwise and unwarranted. I’ll grant that barebacking is, generally, a problem. But it’s a problem that outmoded scare tactics can only exacerbate.

Mark Joseph Stern Mark Joseph Stern

Mark Joseph Stern is a writer for Slate. He covers science, the law, and LGBTQ issues.

Here’s the paradox at the root of the drift toward barebacking: As HIV becomes more treatable, it becomes less scary—and as it becomes less scary, more people will contract it. The syllogism is simple. Traumatic memories of the 1980s are quickly fading from generational memory. Those horror stories and haunting images convinced a generation of gay men to use condoms, but today the landscape is immutably altered. In developed countries, HIV is no longer a death sentence, just a chronic disease. Plus, antiretroviral drugs vastly reduce the risk of HIV transmission between positive and negative partners, opening up a broader margin of error. With the odds seemingly stacked against infection, the question is no longer “why risk it?”—it’s “why not risk it?”

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These are rationalizations, of course, and rather stupid ones. Millions of HIV-positive people don’t know their status or are in denial about it; this dangerous ignorance translates into a high likelihood of infection. Even those on an antiretroviral regimen can easily miss a few doses and become infectious again. And while HIV is certainly treatable, it’s also complicated and expensive. In short, HIV is a disease that no rational person would ever wish to have. The case against barebacking with a non-monogamous partner remains as strong as ever.

If gay men are as smart as anybody else, why can’t they see that? The angry reaction in the LGBT community to the CDC’s latest survey suggests the answer. For decades, we’ve been trying to shame, guilt, and terrify men into using condoms. For many years, it worked. But in 2013, this obsolete tactic has more than earned its retirement. The nightmare of the ’80s doesn’t reflect the reality of HIV today; condom scolds have seen their most effective weapon—fear—defanged. If we want to prevent “a new AIDS epidemic,” we’re going to have to develop new strategies. And the first strategy should be to acknowledge that barebacking isn’t just a low-down and dangerous mistake: It can also be a healthy and fulfilling reward for monogamy.

It might seem obvious that committed, monogamous, seroconcordant gay couples can have unprotected sex. (Serodiscordant couples are another, more complex issue.) But the anguish over AIDS—combined with a strangely durable myth that all gay men are promiscuous—has led to a fraught silence on the topic. In the era of marriage equality and gay monogamy, this silence is anachronistic at best and insulting at worst, implying as it does that gay men are incapable of sexual commitment. Whether one finds monogamy noble or ridiculous,  it’s clearly the gold standard of sexual health. For gay men so inclined, we should heartily endorse the idea of a committed relationship replete with love, support, and, yes, unprotected sex.

That task is made more urgent by a rather inconvenient truth:  Bareback sex feels better for both partners. At some point, almost every gay man will learn this fact—so why lie about it? If we don’t give gay men the promise of the reward, a foreseeable end to the hassles of condoms, they’re bound to get frustrated and either slip up or give up. Giving men the goal of a committed relationship—and with it, the perk of unprotected sex—might convert barebacking from a forbidden fruit to a reward worth working toward.

This is not to say that monogamous barebacking doesn’t carry some risk. Just as condoms can break, so too can partners cheat or misrepresent their HIV status. But you don’t hear these arguments trotted out as a reason for monogamous straight couples to use condoms—and for good reason: They’d be plainly insulting. Any couple in a committed, monogamous, long-term relationship has earned the right to stop using condoms if they so choose. Let’s stop viewing bareback sex as a rash, shameful mistake and acknowledge what it really is: not a deplorable blunder, but a perquisite of commitment.