Michael Shernoff has written a recent book on why US gay men are barebacking (having unprotected anal intercourse). Problem is, his book contains some brilliant insights and new research but also one glaring flaw. What is barebacking? It's not just unprotected anal sex. It has become an identity in itself, it has its own websites and erotic videos, is openly tolerated in some US cruise venues, and its practitioners may view themselves as 'sex radicals.' What causes this to exist? Shernoff identifies several factors. They include weak gay male or bisexual community affiliation, safe sex fatigue amongst previously observant men, perceptions of greater 'intimacy or trust' within partnered unprotected sex, low self-esteem, crystal meth abuse and other substance abuse, depression, and the use of the Internet as a medium for sexual communication and contact. So what are his proposed solutions? Ah, here's where it gets tricky. If barebacking is seen as transgressive, why not redefine what transgression is? Barebacking isn't- it's nihilism and internalised homophobic oppression, buying into the myth that our lives and long-term health don't matter to ourselves or society. So, one response might be exploring what we can specifically do to attract more men who have sex with men into structured LGBT community settings, perhaps through legislative initiatives to question over-intrusive regulation of public sex in areas like lavatories? Safe sex fatigue is more worrying. What might cause someone to stop having safe sex after over a decade of compliance? Unfortunately, Shernoff goes way off track talking about 'negotiated safety' in established partnered relationships. Wrong. I fail to see why he's advocating relaxing safe sex rules as if spousal couples have some sort of infallible open communication about sex outside their primary relationships. The New Zealand AIDS Foundation has never liked the idea because it produces mixed messages and may contribute to increased risk of exposure to HIV. I'm inclined to agree with their assessment. Unfortunately, this is a major flaw in this otherwise useful book. On the other hand, he does raise some useful questions when he explores the role of crystal meth and other recreational drugs in providing contexts for unsafe sex. So, what does one do about this? If the answer is depression and low self-esteem, then antidepressants and cognitive behavioural therapy are useful solutions. As well as that, there is new evidence that even E might produce undue relaxation of safe sexual reinforcement behaviour. As well as the danger caused by crystal meth alone, one also needs to consider polydrug use, which may complicate matters. At the moment, though, it's starting to look as if the latest round of US prevention outreach is working. Is this related to the higher profile of crystal meth abuse prevention on the US West Coast? We don't have available data to substantiate that, but it's worth contemplating. What about the Internet as a new medium for sexual communication and contact? For men who have sex with men outside gay, bisexual or takatapui affiliation, it is not good. There's a stripped down identity politics going on, because men who use the Net to cruise for partners miss out on visual nonverbal and behavioural cues that might warn them that their prospective partners are into risky business. So, how might this be tackled? The NZAF's "Horny As" and couples campaign advert are two ways to deal with existing problems. Another might be automated chatroom simulations that model negotiating for safe sex with partners, virtual partner simulations, webcam safe sex negotiating practice, and more active use of the potentials of the Net. We need more applied research into interpersonal communication, sexual identity formation and community affiliation. So, what should our response be as a community? Get out there and do it, apart from negotiated unsafety, which is a crock. As I've said before, crystal meth abuse prevention needs to be actively owned by our communities, and so does polydrug abuse. With the major exception of the above caveat, though, this is a useful new resource for prevention efforts. We need to get out there and do it. Safe sex is hot, it's pleasurable, and it's transgressive, guys! It's affirming our right to get it off in a society that still imposes too many obstacles to doin' it, and doin' it with respect for ourselves and partners. Without Condoms: Unprotected Sex, Gay Men and Barebacking. By Michael Shernoff (Routledge: 2006) Craig Young - 3rd August 2006