from Medical Issues

Two New Studies Describe Gay Barebacking, Circuit Parties, And Spread of HIV

Researchers have surveyed the attitudes of gay males engaging in unprotected sex and the ideology behind extensive drug use and multiple sex partners at gay circuit parties.

August 29, 2005 - A study published in the August, 2005 edition of the Journal of Sex Research, and one in the Journal of the International Association of Physicians In AIDS Care [JIAPAC] (Vol. 4. No. 2, 32-46, 2005) describe the attitudes of individuals who engage in unprotected anal sex (barebacking) and those who use drugs and engage in multiple sex activities at gay circuit parties throughout the United States.

Northwestern University doctoral candidate Amin Ghaziani and Thomas D. Cook, Ph.D. wrote "Reducing HIV Infecitons at Circuit Parties: From Description to Explanation and Principles of Intervention Design" for JIAPAC.

The authors describe circuit parties as weekend-long erotically charged "drug-prevalent dance events attended by up to 25,000 self-identified gay and bisexual men who socialize and dance nonstop, sometimes for 24 hours or longer."

Ghaziani and Cook state that circuit parties originally began as AIDS awareness events in the mid-80s, but "Although it is unconfirmed, circuit parties may have ironically become potential sites for HIV serotransmission." They maintain that the idea of a link between circuit parties and HIV transmission is "not unfounded, even if it remains speculative."

They note that as many as 25% of the circuit party attendees admit they are HIV positive and use crystal meth as well as ecstasy in risky sexual behaviors.

Most circuit party attendees (95%) admit using psychoactive drugs. Of these, 61% ingested three or more drugs in one night. In addition, 67% reported engaging in anal or oral sex. Only 21% reported engaging in "safe anal sex." Twenty-nine percent had multiple sex partners during a weekend. Of these, 47% reported unprotected anal intercourse (UAI).

Reasons for attending circuit parties varied with 97% saying they wanted to attend to "celebrate and have fun"; 68% wanted "to be wild and uninhibited"; 43% said they wanted sex; and 14% wanted to "forget about HIV/AIDS."

The authors noted that the use of crystal meth at circuit parties is at epidemic proportions.

They propose a causal model that explains the process used by gays at circuit parties who engage in unprotected sex. One part of this model includes elevated libido and the use of drugs that distort judgment. They say: "We posit three mediating mechanisms between party attendance and unsafe sex. One is pharmacological, because club drugs play a central role in risky sexual activity at parties.... Social psychologists have long known that large groups can reduce a person's sense of self and that such de-individuation can loosen normative behavioral and moral constraints .... The final mediating mechanism has to do with feelings of social connectedness and the search for community, experienced at the individual level."

Ghaziani and Cook observe that "Participants report become so immersed in the party atmosphere that they forget about the immediate threat of HIV/AIDS or no longer care about it. They feel invincible and engage in situationally sanctioned practices they would otherwise avoid."

Intervention Strategies

The researchers propose several intervention strategies to reduce the likelihood that HIV infections will occur at circuit parties. One is an educational campaign to explain how different cocktail drugs can "affect cognitive distortion and libidos and hence unsafe sex. Our assumptions are that it is not possible to halt drug use at parties and that the real need is to reeducate and reduce the impact of those drugs that most distort judgment about sexual behavior."

A second approach is to promote and sustain the use of condoms by circuit party attendees. This would include educational efforts by circuit party leaders and hotels catering to party goers.

A third approach is to provide lighting in the outermost portions of the dance floor in order to discourage the "most frenetic encounters that occur at the height of stimulation." The goal is not to discourage anal intercourse, but to encourage it in hotel rooms where gay partners will have a "little more time to reflect on and perhaps even negotiate what they are doing and to distance themselves from the overly eroticized cues and loud music on and around the dance floor."

A fourth approach is to recruit "groups of young men from different cities who are willing to individuate themselves at a particular party (eg., by wearing different clothes from the party 'uniform') and who will then use this situational salience to represent safer sex positions." They will be available to discuss safe sex with participants at circuit parties.

The authors conclude: "Circuit parties are community-building and profit-generating events, and short of legally closing them, they are not likely to go away. Attempts to ban alcohol, prostitution, drugs, and rave parties teach us that moralistic and demonizing legislation only drives such activities underground and may even exacerbate the risk contained with them."

Barebacking And AIDS

John Maxwell, writing in "AIDS optimism, condom fatigue, or self-esteem? Explaining unsafe sex among gay and bisexual men," for the Journal of Sex Research conducted a study of 102 high-risk gay and bisexual men in Toronto. The study was designed to discover the reasoning processes used by these men in engaging in unsafe sex.

Maxwell notes that three key theories have been hypothesized to explain why Men Who Have Sex With Men (MSM) are engaging in unsafe sex: AIDS optimism, condom fatigue, and low self-esteem.

This study "seeks to investigate how well widely-circulating explanations accounting for unsafe sex engage with the social circumstances and reasoning processes of men in their sexual relationships. It examines, in particular, narratives of men who have abandoned condom use altogether and employ a language of barebacking to describe their practices."

Maxwell's study found that many gays engage in unsafe practices because they're in "heat of the moment" situations or in "trade-off" situations where they do not want to offend their sexual partner. These men "trade away safe sex lest it prove an obstacle to sexual interaction."

In addition, personal turmoil and depression are also factors involved in unsafe sex. Individuals who do not believe life is worth living are more likely to engage in practices that expose them to HIV infection.

Maxwell also notes that unprotected sex occurs intentionally. He notes that a minority of HIV-positive men (10) in the study revealed their HIV status right away as a warning to prospective partners. Many HIV positive males considered condom use not needed with other HIV positive partners but wanted to make sure HIV negative partners used condoms with them.

The author notes that "one of the most consistent findings in HIV research is the tendency of couples, whether homosexual or heterosexual, to shift away from safe sex over time."

He also notes that "Monogamy may work... as a safeguard for some couples against HIV transmission, but it can also act as a semiotic snare, setting up the conditions whereby vulnerability to HIV may be increased."

Maxwell says that no one in his study indicated willingness or acceptance of knowingly infecting a partner: "When the premises of individual responsibility are knowingly absent, many express a strong reluctance to allow unprotected sex."

He says that the San Francisco AIDS Foundation has pioneered a program to address the "fundamental problem related to the emergency of a barebacker microculture." The "assumptions campaign" urges men to question their assumptions and to reinforce the use of condoms with men of unknown HIV status.

According to Maxwell, there is need for further research on prevention alternatives to condoms such as microbicides and vaccines and the need to challenge the stigma and rejection of people living with HIV. He also suggests that there is a need "to depict men drawn from a greater diversity of ages and ethnocultural backgrounds as desirable to diminish the power of beauty hierarchies that influence men to 'trade off' safe sex."

Updated: 2 September 2008

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