When Michael Callen, Richard Berkowitz and Dr. Joe Sonnabend wrote How to Have Sex in an Epidemic in 1983, they were viciously attacked. Critics charged that their information—and their invention of safer sex—encouraged gay male promiscuity and exposed an unattractive side of gay male culture. Today, few would argue that the booklet’s risk-reduction message saved many thousands of lives.

It’s instructive to remember this history when reading the highly controversial “Safer Barebacking Considerations” published in this issue of POZ. Written by 28-year-old prevention activist Michael Scarce, “Safer Barebacking” is as clear about risk as “How to Have Sex…” ever was: You can dramatically reduce your likelihood of infection with HIV and other STDs by using condoms, it says, but if you don’t use condoms, this list of measures can possibly help you reduce danger. Circulated at the National Lesbian and Gay Health Association and posted on the www.cruisingforsex.com website, “Safer Barebacking” comes out of a grassroots, Our Bodies, Ourselves tradition of taking charge of one’s own health—the very model pioneered by Callen. Both activists, lacking scientific proof and not willing to wait for unlikely studies, used common sense, personal experience and street wisdom as guides.

No one is suggesting there is anything “safe” about barebacking, especially for people with HIV. Above all, it poses enormous risks of acquiring a whole host of STDs and even reinfection with HIV. Yet when our editorial staff discussed with prevention experts our decision to publish “Safer Barebacking” we found enormous resistance. Don’t talk about “safer barebacking” because there’s no hard data that it works, they told us. Don’t talk about it because that will encourage people to bareback or because barebackers are beyond help. Sound familiar? These objections are similar to those made by critics of condom distribution in schools or needle exchange on the street.
 
As new as the barebacking buzzword, websites and parties may be, unprotected anal sex between gay men has been with us since the beginning of the epidemic, and so have shame, lies and silence about it. Most heterosexuals I know do not use condoms. Many same-serostatus gay male couples I know don’t, either. And just about everyone I know evaluates the risks with as much information as they can get their hands on before deciding what they will or won’t do, with or without a condom, with a potential partner. “Use a condom every time,” the mantra of traditional prevention, has never been a reality for many people.

My generation of gay men was defined by AIDS. We learned about condom use between visits to the hospital and the crematorium. We were immersed—for five, 10, 15 years—in the immediacy and urgency of the epidemic; safer sex became a holy grail.

This is not so for younger generations. Twentysomething gay prevention activists report that the last thing many of their peers want to hear about is HIV. They’re AIDS’d out. Many do not live by the condom code and—short of enduring the mass deaths my generation endured—they never will. To reach these men, activists in cities nationwide have worked to develop a new model—nonabsolutist, nonpanicked, nonjudgmental prevention that focuses on community building, sexual empowerment and harm reduction. Negotiated safety—such as “bareback” sex between two same-serostatus partners—is an essential aspect. A just-released Australian study shows that this strategy is far from 100 percent successful, but still an improvement on a one-size-fits-all, “just say no” approach.

The tragedy is that my generation of AIDS opinion leaders denies what these younger men say they need while holding tight to prevention dollars. For the most part—GMHC’s harm-reduction program is a rare exception—we’ve persisted in throwing money at increasingly ineffective campaigns designed for a different era. And we’ve forgotten that disapproval of barebackers’ behavior has no more relevance to how those funds should be spent than does the disapproval of homosexuality, teen sex or IV drug use.

It was easier to be honest—and effective—in prevention strategies 15 years ago because they were developed solely by the community most profoundly impacted. There were no AIDS bureaucrats or politicians, no government grants with “content restriction” strings attached. But grass-roots prevention is alive and kicking—if badly underfunded—and “Safer Barebacking Considerations” is one small part of it. “The next time you’re in a sex club and see unsafe sex, tap the top on the shoulder and hand him a condom,” Michael Callen once wrote. Michael Scarce would update that with: “And if he refuses the condom, hand him this harm-reduction list.” That’s the spirit in which POZ presents “The Boys Who Bareback.”