ABSTRACT
The term ‘bareback’ appeared in the gay press in the mid-1990s referring to intentional condomless anal intercourse, mainly among HIV-infected gay men (Gendin 1997). However, by the time Silverstein and Picano published The Joy of Gay Sex (2003), bareback was defined simply as condomless gay sex. Researchers who saw the need to operationalise the term chose ‘intentional condomless anal intercourse in HIV-risk contexts’ (Carballo-Diéguez and Bauermeister 2004; Suarez and Miller 2001), noting two key elements – intention and risk – that might distinguish the term from other less precise definitions. Others defined it as: ‘intentional anal sex without a condom with someone other than a primary partner’ (Mansergh et al. 2002); ‘intentionally seeking or engaging in unprotected anal sex among HIVpositive gay men’ (Elford et al. 2007); ‘intentional unprotected anal intercourse regardless of serostatus or partner type’ (Halkitis et al. 2003, Tomso 2004); or any ‘sex that occurs without the protection provided by a condom’, not limited to gay men (Gauthier and Forsyth 1999). Lacking a standard definition of, and consensus on, the role that intentionality of condomless sex and HIV-transmission risk (or lack of it) play in bareback sex, some researchers went back to the sources, i.e. asking gay men what bareback sex means. Brief surveys, sometimes no longer than five minutes, were administered online or to community samples asking respondents to define bareback sex or presenting scenarios with degrees of intentionality (Halkitis 2007; Huebner et al. 2006). Yet respondents were not asked to describe their understanding of the term, and the HIV status of protagonists was not included. As a result, proportions of respondents endorsing different definitions vary widely. Given this definitional imprecision, there is difficulty in comparing findings and developing evidence-based prevention responses. Researchers have also tackled a related topic: bareback identity (Halkitis et al. 2005; Wolitski 2005). Based on the idea of a distinct bareback identity, studies have compared individuals who identify as barebackers with those who do not (Halkitis et al. 2005; Halkitis 2007). However, the operationalisation of the term ‘barebacker’ as identity is also not clear in the literature. Our Frontiers in Prevention study was designed to explore the perspective of men who report engaging in bareback sex on the meaning of bareback sex, which words besides ‘bareback’ are used to name the practice and whether respondents identify as barebackers. Furthermore, we sought to redefine the term within a conceptual model that could orient future work.
