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Toby is a white, year-old, HIV-negative gay man who came to see me because of depression and loneliness. A successful and ambitious architect, he worked exceptionally long hours to make partner in his firm. His last relationship ended during his final year of graduate school, after 2 years, and he had not had another partner in almost 10 years. Because of his intense focus on work, Toby had not taken the time to cultivate deep friendships. He did have a group of people with whom he would go to clubs to dance a few times a month. Typically, during those outings, he would take MDMA Ecstasy and smoke marijuana.

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On the weekends when Toby stayed home, he either met men in online chat rooms for sexual hookups or went to sex parties.

Again, his attitude toward condom use was passive. If the other man wanted to use them, that was fine with him.

But if the other fellow never brought up the topic of condoms, neither did Toby. It was clear that he was well informed about HIV transmission and about the risk he took of becoming infected by barebacking. When I explored this passivity toward using condoms, he explained that he worked such long hours and so intensely that when he did have time off it was essential that he be able to stop thinking and just go a bit wild and lose control.

Ostrow and Shelby describe psychotherapy with men like Toby who use drugs to enable them to lose inhibitions and engage in fantasy sex that they might otherwise have difficulty engaging in without guilt or remorse.

Toby was an only child raised in the Midwest by a devout Baptist single mother who had been deserted by Toby's father shortly after Toby's birth. Toby came out to his mother after he finished graduate school and moved to New York.

She did not react well to the news, retreating into the condemning language of her church. She told her son that being a homosexual was going to land him in hell unless he repented and changed his ways. She also told him that he was going to get AIDS because he was gay. Toby sounded bleak when he described the Christian literature she regularly sent him about the evils of homosexuality and how gays were being plagued by AIDS as punishment from God.

I asked Toby what he thought about his mother's views of his sexuality. He said he was frightened - what if what she said was true?

He said she was relentless about sharing her views on Toby's "sinful affliction," even after Toby asked her not to raise this subject every time they spoke. I was surprised to hear that he continued to speak with her once a week and to visit with her for a week at Christmas.

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We explored his conflicted feelings about his relationship with his mother. On the one hand, he recognized that the way his mother treats him was damaging to his self-esteem and was deeply painful.

On the other hand, as the only child whom she struggled to raise, he felt a strong sense of loyalty and obligation to her. I shared with Toby my concern that his barebacking activity was putting him at risk for fulfilling his mother's prophecy that he would get AIDS.

He said he worried about it at times, and he had no conscious desire to contract HIV, but he was not willing to kill his exact expression the spontaneity of his recreational sexual exploits.

In the rest of his life, he was responsible and reliable. In this one area of his life, he wanted to be totally free.

I wondered if Toby's behavior was an unconscious desire either to prove his mother right or to get sick and die as a hostile "fuck you" to his mother. I did not begin to share any of these possibilities with Toby until many months after our initial consultation.

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Every few months Toby would get retested for HIV, and as of this writing he remains HIV-negative. Fifteen or 20 years ago, I would have been appalled and quite judgmental about Toby's behavior and probably gone into overdrive to try to save Toby from his own impulses. Most of the time, these clients just stopped therapy with me. They did not want or need a rescuer, as well-intentioned as I was. Although it still hurt to hear Toby describe the potentially deadly risks he was taking, I had to practice patience, compassion, and empathy.

He was the only one who could take himself out of these high-risk situations, and then only if and when he decided that he wanted to. Along with my protective feelings for this young man, I felt clinical curiosity about what was driving Toby to take sexual risks with such an apparently casual attitude.

Researrs have been eager to find out more about the category of barebackers that Toby falls into - men who are not trying, at least consciously, to become infected with HIV, but who are willing to take risks in order to satisfy deep intrapsychic and interpersonal needs.

This chapter asks a lot of tough questions: Is barebacking pathological? Is it correlated to personality disorder? Is it all about sex, sensation-seeking, and pleasure? Or is it, as paradoxical as this may seem, actually an attempt to take care of oneself and to forge a deeper intimacy, closeness, and even spiritual communion?

We will look at how current antiretroviral therapies may affect decisions to have uag4food.comotected sex, and how fear and lack of fear about the danger of HIV infection play into the decision to bareback.

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The question of whether sex without condoms in the age of AIDS can ever be a rational decision will be explored. As the title of Chapter promises, there are no easy answers to why men have sex without condoms. This chapter offers multiple meanings that men who have sex without condoms themselves attribute to the behavior. The more we can understand the underlying motivations of uag4food.comotected and unsafe sex, the better we can have effective community conversations about how to prevent the spread of HIV and other sexually transmitted diseases STDs.

Lest we forget the potential serious consequences of having sex without condoms, I include the latest information about the health risks of condomless sex, discussing the relative safety of HIV-positive men who bareback with other infected men. There are abundant theories but no definitive answers about why gay men take sexual risks. After more than three decades of safer sex messages against the backdrop of gay men sickening horribly and then dying, new medical treatments have stemmed the tide of the pandemic and offered real hope for longer-term survival to people with HIV.

Gay men want the AIDS epidemic to be over and want to be able to have sex without fear. They want to celebrate their desire without having to worry, negotiate, be fearful, or keep a shield of latex between themselves and their partners. Younger men want to experience pre-AIDS sex.

Queer theorist Tim Dean writes: "In view of statistics on new seroconversions, some AIDS educators have begun to acknowledge that, unlikely though it may seem, remaining HIV-negative in fact poses significant psychological challenges to gay men" p.

To those who have not been working in the gay men's community for the past 25 years, this statement might seem absurd, but it is true that HIV-negative gay men face unique challenges that make it seem almost easier to seroconvert. San Francisco Bay area psychologist Walt Odets was one of the first mental health professionals to question why gay men who had thus far escaped becoming infected with HIV were placing themselves at risk for becoming so. Odets described HIV-negative men who struggled in a world and gay community that, however unintentionally, considered their difficulties inconsequential as compared to those of men who were fighting for their lives.

These uninfected men's growing invisibility triggered old childhood feelings of being an outsider, and for some, contributed to an acute psychological crisis that often created a confluence of behaviors and thought patterns that placed them at risk for contracting HIV. Some have suggested that during the '80s, gay men unconsciously colluded with the general public's equation of a gay identity with an AIDS identity Odets, ; Rofes, Some of these men felt that they were not entitled to express their deep fears that they might become infected or discuss their loneliness or burnout when so many peers were dying around them.

The dynamics described by Odets and Ball are part of the communal and psychosocial realities that early in the epidemic played a role in contributing to the spread of HIV. Should we conclude that safer-sex campaigns have lost their effectiveness today because gay men are no longer afraid? In the last 20 years, the roar and urgency of HIV prevention campaigns have faded.

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British psychologist and researr Mille Crossleywrites that one factor might be a decrease in the effectiveness of the "health promotion" campaign to change gay men's sexual behavior. Gay men who come out today are raised with AIDS awareness and come out to a chorus of safer-sex messages.

But Crossley notes that most "health promotion" campaigns - for example, convincing people to stop smoking and lose weight - have only limited long-term success. She wonders if the "safer-sex" messages ever had much effect on gay male sexual behavior. Crossley raises an interesting question that is difficult to quantify.

Obviously, there were a confluence of factors in the early days of the epidemic - most prominently fear, the horrors of sickness, and grief of deaths - and these things made safer-sex AIDS education programs more compelling to the target audience. Crossley suggests that it is impossible to evaluate the efficacy of safer-sex messages in and of themselves since concurrent to when they first began appearing, gay men were overwhelmed by the terror that they might be infected by the then-new disease that was rapidly killing their friends and lovers.

Though highly unscientific, comments shared with me by men who attended the safer sex programs I ran in the s the workshops will be described in more detail in the next chapter reported that they felt that these interventions proved helpful to them for changing how they had sex in response to AIDS. The men who spoke or wrote to me after attending the workshop often described an enormous relief.

They spoke of how important and useful it was for them to simply be in a room with other gay men sharing feelings about how sex needed to change. They also appreciated the permission that was given during these workshops to remain sexually active, albeit with some big differences from what they were used to. They reported being thrilled to be able to participate in a process that helped them reclaim the joy and fun of gay sex amidst all of the sex-negativity and sex-equaling-death messages that were inundating them.

Thus, participating in this AIDS prevention workshop helped scores of men feel confident of their ability to make the necessary sexual changes and sustain them. There are numerous theories for why gay men engage in uag4food.comotected sex, and research has explored a wide variety of possible rationales for the behavior.

These include:. A sense of the inevitability of becoming infected with HIV as a gay man Kelly et al. There are probably a multitude of other issues at play as well. As psychologist and former researr at the CDC Ron Stall was quoted as saying in an article in the Manhattan gay newspaper Gay City News"There are studies that demonstrate a variety of psychosocial health issues, including depression, antigay violence, childhood sexual abuse, or substance abuse, can lead gay men to have unsafe sex" Stall, quoted in Osborne,p.

In my own practice, I have identified several factors that appear to lead to sexual risk-taking: loneliness, being HIV-positive, having unmet intimacy needs, feeling alienated from the gay community, being in love, and a craving for deeper intimacy and trust.

In San Francisco, Morin and colleagues identified a number of issues that contributed to the decisions gay men make to bareback.

These include p. Isolation and loneliness among gay men lead to poor self-esteem and taking risks in an attempt to connect to others sexually.

Social power imbalances related to race and class impede equitable sexual negotiations. Drug use among gay men interferes with the ability and desire to practice safer sex. While a wide spectrum of rationales for barebacking exists, subtle distinctions must be made around the context of the behavior. As Suarez and Miller write, "The motivation for engaging in UAI with casual and anonymous partners may differ significantly from the motivation for engaging in UAI with regular partners.

In Toby's case, his barebacking was not related to a desire to feel closer to a beloved partner but rather his desire to connect sexually and socially with other gay men and to feel uninhibited and free. Toby did exhibit symptoms of an ongoing low-grade depression but otherwise presented as an emotionally stable adult but one who was wrestling with unexamined drug dependency issues.

Two researrs at UCLA developed a model of sexual decision making to assess rationales of adults who have uag4food.comotected sex. Pinkerton and Abramson found that "for certain individuals, under certain circumstances, risky sexual behavior may indeed be rational, in the sense that the perceived physical, emotional, and psychological benefits of sex outweigh the threat of acquiring HIV" p.

This seems to be precisely Toby's relationship to barebacking: the benefits gained - shaking off the constraints of a very buttoned-up work life and having satisfying sexual experiences that also fulfilled social and emotional needs - outweighed the potential risk of becoming HIV-positive.

These researrs state that they do not mean to imply "that risky behavior is rational in any objective sense - only that, given certain sets of values and perceptions, engaging in unsafe behaviors may appear to the individual to be a reasonable gamble" p.

They also stress that what is rational is a highly subjective matter. Pinkerton and Abramson describe three factors that influence an individual's subjective assessment of the relative risks of various sexual behaviors:. In order for an individual to behave rationally while barebacking, his fear of AIDS needs to be relatively small in comparison to the satisfaction derived through uag4food.comotected sex. This was exactly how Toby reported feeling early on in therapy.

Yet as our work progressed, he began to express a profound ambivalence about becoming infected. Part of him wanted to stay uninfected, and yet part of him felt unsure of whether he would be willing and able to experience what to him seemed like deprivation of his spontaneity if he were to increase his efforts to keep himself HIV-negative.

Pinkerton and Abramson conjecture that for many Americans, "fear of AIDS" may be synonymous with "fear of death by AIDS," and that fear of death is not nearly so great as might otherwise be supposed. Grov also discusses a category of barebackers that he labels irrational risk takers. Suarez and Miller feel that many gay youth who bareback fall into the category of irrational risk takers since they may have never known anyone with HIV and hold pessimistic attitudes about the future largely related to their being gay.

Suarez and Miller feel that this combination often leads to young gay men especially young gay men of color taking sexual risks. Pinkerton and Abramson offer possible explanations for the tendency to underestimate the personal risk associated with risky sex, even among "high-risk" gay men. First, they cite a study showing that no one sees himself as the "type of person who gets AIDS" Madake-Tyndall, They also suggest that the "I'm not the type" fallacy is often extended to sexual partners.

As they note, "Thus, the frightening picture that emerges is one in which it is only the other guy who gets AIDS. They also discuss that results from cognitive psychology indicate that in general people tend to view themselves as "luckier" than the norm, and that this extends to the belief that they will not be the one to get AIDS.

Again and again, we return to the poignant question of why a person would put his life in jeopardy for pleasure. Sex is a source of pleasure that encompasses biological, psychological, and sociological realities Reiss, Sex is not only about pleasure. It can be about belonging, feeling desired, desiring semen, organizing one's life, and providing meanings to one's life. The essence of sexual encounters is bonding, blending, mutual pleasure, and loss of inhibition.

HIV lurking in the background places strict boundaries on all of these cts of sexuality" Coates,p. The equation for evaluating how the benefits of barebacking weigh against the inherent risks is not simple. Tim Dean writes: "Most people can't comprehend why anyone would risk death for a good fuck.

From a certain viewpoint, unsafe sex appears as inconceivably self-destructive behavior. Indeed, while such health-threatening practices as smoking, drinking, and drug abuse must be indulged in repeatedly over a substantial period before they are likely to cause harm, HIV infection can result from a single uag4food.comotected encounter.

Casual, anonymous sex without a condom seems suicidal" p. But the long-term effects of HIV infection on health are easily denied when faced with the immediacy of sexual pleasure, particularly if one is using drugs that fog one's judgment.

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One lens through which decisions to bareback need to be viewed is the role of pleasure and how the search for erotic pleasure is intimately related to desire. For one thing, sex without condoms feels much better and is vastly more spontaneous than having to stop the action, unwrap a condom, and properly put one on.

Many gay men are articulate about how thrilling and intimate it is to the feel of the warmth of a lover's unsheathed penis and the smooth stimulation of skin against skin. Carballo-Dieguez interviewed a small sample of men who identify as barebackers. One man told Carballo-Dieguezp. The pleasure I feel when I'm having sex, especially if I'm stoned, is so amazing.

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Passion does not call for protection in my mind. Passion is a very raw emotion. It is not easy to feel real passion, because there are so many barriers put up and so many acts that people have in themselves that they want to express during sex, that protection does not fit in the fantasy. Much as we try to eroticize safer sex, there is no way around the fact that condoms both decrease the sensation of anal intercourse and interrupt the spontaneity of the sexual act.

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Sexual fulfillment "encompasses a range of physical, emotional, and psychological factors including, but not limited to, physical pleasure and release, emotional intimacy and security, enhanced self-esteem, and actualized sexual identity. As previously discussed, recreational sex has been identified by at least certain segments of the gay male community as a means of personal fulfillment and an expression of enhanced freedom and self-esteem. An active sex life is seen as a indication of attractiveness and vitality.

A gay man who wants to feel liberated, hot, or sexy might view sex without condoms as the best route to fulfilling his desire to feel any of those ways.

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Zuckerman finds that sensation-seeking and impulsivity are not the same thing, though they are related. They looked at how sensation-seeking, and an individual's affect and the ways risk affects the ability to become sexually aroused, contribute to why men have uag4food.comotected sex.

These factors illustrate how intrapsychic and interpersonal issues converge to influence an individual's likelihood of taking sexual risks. For instance, men who are high sensation-seekers may be more likely not to use condoms since they value the intensity of skin-on-skin contact during anal intercourse. In short, one man's need for a higher degree of sensation can result in his initiating sexual risk-taking, taking his intrapsychic need into the interpersonal sphere.

Numerous researrs have studied the connection between sensation-seeking and men who bareback. Pinkerton and Abramson and Bancroft et al.

An individual who is highly sensation-seeking is more likely to downplay the risks associated with a particular behavior if he has previously engaged in the behavior in this case UAI without negative consequences, such as becoming infected with HIV. Thus as Pinkerton and Abramson point out, men who are high sexual sensation-seekers seem not to be unaware of the risks associated with their behavior but choose instead to accept these risks.

Some of these men may be in denial about the potential risks to their health. Others may simply compartmentalize the risk and not have it affect their behavior.

Yet other men engage in a form of magical thinking - believing that they are invulnerable to infection. There are also men who know and accept the risks and are willing to factor them into the equation as one potential cost to an otherwise important, pleasurable, and valued behavior pattern. Scragg and Alcorn and Miller, Lynam, Zimmerman, Logan, and Clayton find that both extraversion being highly outgoing with the ability to easily engage other people socially or flirtatiously and sensation-seeking are related to the desire for a greater number of sexual partners.

This seems to make sense since sex with more than one person is inherently a social activity and requires one or more partners Miller et al. Schroth also demonstrated that in a sample of gay men he studied there was a strong correlation between sensation-seeking and high number of sexual activities and high number of partners.

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Interestingly, this same study did not find any relationship between sensation-seeking and unsafe sexual behavior in the well-educated men among the sample surveyed. This finding is contradicted by empirical observations of the well-educated men I see as psychotherapy patients who bareback and often exhibit characteristics of sensation-seeking.

Hoyle, Fejfar, and Miller conducted a quantitative review of the empirical literature on "normal" personality and sexual risk-taking in which sexual risk-taking behaviors were defined as numbers of partners, uag4food.comotected sex, and high-risk sexual encounters, including sex with a stranger. Their work found that a high level of sensation-seeking predicts all forms of sexual risk-taking covered in their review. There was a consistent, but not strong, positive association between impulsivity and sexual risk-taking, with these authors noting that there was a problem in the inconsistent ways that impulsivity was defined.

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Seal and Agostinelli showed that impulsivity was one important factor among men who had UAI. In discussing what they call "rational risk-takers," Suarez and Miller note that there is a group of men whose sexual behavior is based on "rational" consideration of the risks of specific sexual acts.

Among this group are couples who are not sexually exclusive who have negotiated safety 1 agreements, and HIV-negative men who only are the insertive partners during condomless anal sex. Suarez and Miller describe a phenomenon that some men use as part of their "rational" approach to barebacking as "serosorting. Serosorting relies on men discussing HIV status with potential partners and only engaging in risky behaviors with those who are believed to be of a similar serostatus.

A study conducted in the San Francisco Bay area among a multiethnic sample of MSM Mansergh et al. Despite the limitations of serosorting, Suarez and Miller report that many barebackers employ this strategy. As evidence, they point to the plethora of personal ads on Web sites devoted exclusively to barebacking as well as on Web sites where gay men cruise for sex where men state their own HIV status and the desired status of potential partners.

Hort posits that barebacking itself is a serosorting strategy insofar as barebacking is often a way for HIV-positive men to disclose their status and assume that anyone who is willing to have unsafe sex with them is also already infected. But as will be discussed in Chapter 5, this assumption is incorrect. Suarez and Miller note that many barebacking ads are posted by men who claim to be HIV-negative and state explicitly that they will only bareback with other uninfected men.

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Whether or not a man is making a rational choice when he decides to bareback is often difficult for others to assess, even psychotherapists who must contend with their own judgments and feelings about this particular highly charged, high-risk behavior.

But for barebackers who are neither actively nor passively suicidal, there is an internal logic that makes sense to them, especially when the behavior occurs within specific contexts. For example, one rationalization for engaging in unsafe sex is the belief that having an HIV infection will alleviate their worry about becoming infected. This dynamic was first reported by psychologist Walt Odetswhen he described men who felt that they were not destined to survive the epidemic and therefore had no motivation or reason to practice safer sex.

Odets writes that many survivors of the epidemic have a sense of the inevitability of their "catching AIDS.

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Since he almost never used condoms but made every effort to limit his sexual partners to other uninfected men he met, he decided to have "HIV-" tattooed on his left arm since he disliked the necessity of asking about HIV status. Immediately after getting himself tattooed he discussed his feeling that it was only a matter of time until he eventually got infected. At first, his reasoning seemed as slippery as a child telling himself that he might at on the test because he was destined to fail, and getting caught would spare him the misery of bringing home an F.

This kind of illogical logic is not uncommon, even in adults. In the early s I remember working with Matthew, a year-old, biracial Wall Street professional who came to see me. He was so worried about whether or not he had become infected during a recent weekend-long sexual orgy that it was interfering with his very demanding job.

As he described himself, usually he was conservative about sexual risk-taking to the point that his unwillingness to tongue-kiss brought several promising relationships to an end. Yet, there were certain situations in which he engaged in UAI, though only as the insertive partner, feeling that while this was not completely risk-free, it was relatively safe. During our first therapy session, Matthew commented that since he was a sexually active gay man, it was inevitable that he would become infected with HIV.

This gave him some inner permission to take sexual risks. Vincke and colleagues found that "the incorporation of semen is an important value for many in gay cultures, a means of showing devotion, belonging, and oneness. Unsafe sex can therefore be an expression of positive values and of good feelings" p. There is something deeply erotic, profoundly connecting and, some feel, even sacred about one person giving his most private and special fluid, semen, to the other as a gift of love and a symbolic joining of two souls.

The many levels of meaning and special significance that giving and receiving of semen has for gay men cannot be underestimated as a contributing factor to the rise in barebacking - especially in romantic couples, as will be examined in Section 2 of this book. Early in the second decade of the AIDS epidemic Odets wrote, "Now that a decade of prohibition has made semen exchange relatively unusual and 'special,' it has become all the more powerful and meaningful" Odets,p.

Obviously, what it means to give or receive semen varies from one gay man to another. Some have described drinking semen as literally ingesting the vitality, strength, manliness, or very essence of the man whose semen they either drank or received anally. There are men who feel that sharing their own or receiving the semen of a lover is a visceral as well as symbolic gift of love or a spiritual communion.

There are those who revel in experiencing the esthetic and sensual pleasures in giving or receiving semen. By no means is this a comprehensive list. The meaning of sharing semen between two men is as varied as the men who engage in this act. Since attempts to satisfy sexual desire that go beyond masturbation necessarily involve interacting with one or more people, attempting to categorize an individual's motivations for barebacking as either being predominantly intrapsychic or predominantly interpersonal creates an artificial distinction that grossly oversimplifies the dynamics at play.

As Bancroft et al. Bay-area psychologist Stephan Morin writes, "The normalization of the term 'barebacking,' combined with media attention and community-level discussion about it, have contributed to the perception that the behavior is widespread in the community, creating a [new] social pressure to conform" Morin et al.

Recent research finds that men who forego using condoms feel there has been a decrease in social supports for staying safe as well as a shift in community norms toward increased acceptance of unsafe sex. In effect, they feel some peer pressure to bareback Morin et al. The shifting winds of the gay sexual culture have a huge impact on members of a minority group that is partially defined by sex and desire.

As I pointed out in the previous chapters, accepting, internalizing, and adopting sexual norms are part of most gay men's core identification as gay men.

Thus in the immediate aftermath of the onset of AIDS, the community norms for sexual behavior shifted from the anything-goes realities of a pre-AIDS world to adopting safer sex, which allowed many men to remain sexually active.

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Safer sex and condom use were viewed as core elements of gay pride and as part of the glue that bound the community together. Currently, with the waning of the most obviously horrific cts of AIDS, the sexual status quo is once again in transition, but this time away from the standard of safer sex, as the pendulum swings back in the direction it had been moving prior to Bancroft et al. They found that the patterns of contact, where people met for sex, and how many partners they had was related to whether or not they took sexual risks.

Their findings showed evidence that much "cruising" behavior by men in public places that results in public sex is relatively low-risk because the sexual activity is usually limited to mutual masturbation or oral sex. In contrast to the researrs above who have shown that for some gay men barebacking is a rational activity, there are social scientists who have tried to determine whether men who bareback have a documented higher level of mental disorders than do men who do not take sexual risks.

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Gerrard, Gibbons, and McCoy have shown that affect can influence judgment and decision making. They found that some depressed, anxious, or sad people take greater sexual risks while others who have the identical affect are more sexually conservative.

Thus it seems apparent that affect alone is not the determining factor in why some gay men bareback. Some researrs investigated whether suffering from an anxiety disorder could increase an individual's risk-taking behaviors. Yet neither of these studies demonstrated that a correlation existed between the way the participants used sex and a diagnosable mental disorder.

Research by Halkitis and Wilton on the meanings of sex for HIV-positive gay and bisexual men found that of the men interviewed, most discussed the role of sex as a mood stabilizer, stress reducer, and facilitator of intimacy. Though Halkitis and Wilton were only reporting on HIV-positive men, my clinical experience shows that most gay men, no matter their HIV status, would concur.

Clearly, some people use sex to anaesthetize themselves to tense or difficult feelings or situations.

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This seems to speak directly to at least part of the function that sex in general and sex without condoms served for Toby in coping with his everyday sadness, loneliness, and other nonpathological feelings.

One of the most common symptoms of depression is decreased libido, so it is curious that sex drive, paradoxically, seems to increase in some depressed gay men.

Psychologist Thomas Coates, who is on the faculty at the David Geffen School of Medicine at UCLA, suggests two possible explanations: "One possibility is that these men seek out sexual partners to alleviate depression. Another is that depression decreases self-esteem, leading these men to engage in sexual behavior that they might otherwise not find acceptable.

Rather than driving away a potential sexual partner by trying to negotiate sexual behavior, these individuals may be willing to accept whatever sexual activities the partners want as a way of achieving relief from depression and isolation" Coates,p. Coates also points out that there is now research that seeks to explore what the relationship might be between depression, depressive symptoms, and gay men taking sexual risks. He states, "In particular, studies suggest a complex interplay among a variety of factors that interact with depression and the conditions that increase risk or undermine risk reduction" Coates,p.

An excerpt from Without Condoms: Uag4food.comotected Sex, Gay Men & BarebackingRoutledge, , List $ > "The terrible thing in this world is that everyone has his reasons." > > Octave, The Rules ofEstimated Reading Time: 9 mins Less than a week after appearing at the closing ceremony of the London Olympics, Prince Harry was photographed nude at a hotel suite in Las Vegas after a night of partying. NBC's Stephanie Gosk It can be hard to talk about masturbation. You may be embarrassed to ask your parents or even your friends about it. Talk to a doctor or health counselor you trust. Their job is to talk to patients honestly about their bodies. They can answer any questions you may have about ag4food.comted Reading Time: 2 mins

This story has been shared 61, times. Share this: Facebook Twitter Flipboard WhatsApp Email Copy. Living Share this: Facebook Twitter Flipboard WhatsApp Email Copy. View author archive Get author RSS feed. Name required. Email required. Comment required. Share this article: Share this: Facebook Twitter Flipboard WhatsApp Email Copy. Read Next These men are literally having a d-k-measuring contest. Share Selection. Listen Now. Now On Now on Page Six.

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