title: AIDS optimism, condom fatigue, or self-esteem? Explaining unsafe sex among gay and bisexual men.
abstract: This study examines leading explanations for unsafe sex in light of in-depth interviews with 102 high-risk gay and bisexual men in Toronto to see how well they engage with the social circumstances and reasoning processes of men in their sexual relationships. We argue that there is an inadequate fit between some of the leading explanations and the discursive accounts provided by high risk men themselves. Their accounts focus on unsafe sex occurring as a resolution to condom and erectile difficulties, through momentary lapses and trade offs, out of personal turmoil and depression, and as a byproduct of strategies of disclosure and intuiting safety. This study examines, in particular the circumstances and rationales associated with men who identify their practices as "barebacking." We conclude with recommendations for communicating prevention messages to those most at risk based on the self-understandings of gay and bisexual men who most frequently practice unprotected sex.
authors.affiliation: University of Windsor, Department of Sociology and Anthropology, Windsor, Ontario, Canada. adam@uwindsor.ca
authors.forename: Barry D
authors.initials: BD
authors.lastname: Adam
authors.forename: Winston
authors.initials: W
authors.lastname: Husbands
authors.forename: James
authors.initials: J
authors.lastname: Murray
authors.forename: John
authors.initials: J
authors.lastname: Maxwell
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control* / Q000523:psychology* / Q000635:transmission; D000328:Adult; D001727:Bisexuality / Q000523:psychology*; D017280:Condoms / Q000706:statistics & numerical data*; D003863:Depression / Q000523:psychology; D007172:Erectile Dysfunction / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D007389:Internal-External Control; D007406:Interview, Psychological; D019545:Intuition; D008297:Male; D008875:Middle Aged; D009864:Ontario; D012649:Self Concept; D012747:Sexual Partners / Q000523:psychology; D014342:Truth Disclosure; D047568:Unsafe Sex / Q000523:psychology*; D055815:Young Adult