In an article posted on LifeLube, Charles Stephens wonders what oral prevention and rectal microbicides, amongst others, might mean for HIV prevention and pleasure, risk and taboo.

As “condom-centric” prevention interventions are failing (the intervention, not the condom), hope and expectations are high that other prevention strategies such as PrEP and microbicides could succeed where condoms are failing. However, discussion and debate are rife around these interventions and they are important because we need to think ahead about how they will affect our sexual behaviour.

The problem is “how” to think these new interventions and their impact.

Stephens’s argument is that no-one back then in the 80s could have known the consequences of condom-centric HIV prevention and what Stephens sees as its impact on safe sex. “The condom-centric approach to gay men’s HIV prevention, influenced the rise of barebacking, if not created it. Condom-centric HIV prevention created the “cum pig.”

Thought Stephens is right in highlighting our reccurent inability to foresee the future, it is rather weird to suggest that “The condom-centric approach to gay men’s HIV prevention, influenced the rise of barebacking, if not created it.” If true, this would mean that barebacking never existed before, something that is plain nonsense and that Stephens acknowledged, adding “Certainly “raw” sex has always existed, and the exchange of bodily fluids, and so forth.” That condom-centric prevention has led to condom fatigue and a decrease in condom use is a more appropriate way to describe where we are. But let’s face it, between 1980 and now, what other HIV prevention as good as condom was there and is there? So if the argument is about the fact that what we do today will have consequences tomorrow, Stephens piece is a lot of ink wasted on a truism.

But it is not and as there is room for discussion about these potential new HIV prevention methods and their impact. The question is what impact are we talking about? Are we talking about their impact on how gay men think about their anuses? Or are we talking about how these interventions will impact on an epidemic for which there is still no treatment, for which there is still people who don’t know they are infected and still people who don’t have access to treatment?

What I would like gay men to think a bit more about is the impact of their personal sexual practice, demands and choices on the overall HIV epidemics and a bit less about “… how the potential meanings we attach to both anal sex and our anuses will evolve, along with our sexual landscapes and fantasies.” There is a deep divide here revealing of different perspectives of life, its meaning and our respective role in building a society that works for all and protects all. The parallel with the ongoing debate about medical care in the US is another example of a divide between people, continents and cultures.

Indeed, I wish people could see beyond the debate about sex, bareback or PrEP as I strongly believe these to be only the expression of a deeper malaise and vacuum, that of our “individual identities”. The key sentence in Stephens post is “These days individual identities and tribal affinities seem to be increasingly informed by one’s desire to bareback or not.” But one could put pretty much anything after this “by” and it would make sense.

• The number of friends we have on Facebook
• The model of mobile phone we have (notice the “I” in Iphone or Ipod)
• The clothes we wear
• The school we have been
• The book we read in the underground
• The club and parties we go

Individuals identities have always been informed by a broad range of factors and to reduce them or even isolate them to “one’s desire to bareback or not” as a defining factor is ignoring the complexity of human nature and social interactions, an omission not uncommon in a world that is more and more obssessed by navel watching and a cult of one’s personnality and individuality. It is also reducing gay men’s identity to their sexual activity. I would like to think and to believe that gay men are as complex as any other human being because such reductionist approaches are in part responsible for the failure of HIV prevention in many instances.

But let’s stop pussy footing for a moment: barebacking is a privilege in those countries where condoms, VCT and medical care are readily available. Elsewhere it is the harsh reality for those who do not have the prospect or possibility to receive appropriate information about HIV, being tested for HIV and to receiving appropriate care. Where most MSM vulnerable to HIV live, barebacking is not an “identity”, it is a fatality.As such “barebacking” is a Western invention, a personal choice in defiance of reason and justified on the ground of “sexual rights” (but rarely duties). This is not an attack on barebacking or barbackers or Stephens’ writing, but an assault on complacency and shaky justifications grounded in individual rights, personal responsibility and mutual consent.

Stephens article is of value as it offers a traditional western-centric view of sexuality, that of “gay men”. But elsewhere, many men who have sex with men do not always identify with the “gay culture” as it is defined in the West; they don’t think that they are barebacking when they are having unprotected sex with other men, they don’t engage in a deep psychological self analysis seeking to understand the deep relationship between their anuses and their identity as this relationship is pretty much well defined contextually (a Katoye in Thailand knows very well who she is, how she is excepted to behave and has little freedom to do otherwise). That’s Western “foot massage” for the rest of the world. Besides, it is dubious that many gay men in the West would engage in the same existentialist self-questioning process before, whilst or after having sex. The proof is in the so many gay men who engage in unsafe sex despite swearing always practising safe sex.

For Stephens, condom-centric HIV prevention also criminalised semen becasue as soon as our semen started to be seen as lethal and deadly a taboo was created and led to a “heightened awareness and eroticization of cum.” But the fascination of men and women with semen is both old and universal and can be found in the Far East to the West, from the pagan to the secular, the Bhagavad gita to the Bible. The possibility that gay men suddenly started to worship semen because of condom-centric HIV prevention ignore semen’s long history of worshiping, eroticisation, and glorification.

Stephens rightly concluded that “as we inject biomedical science deeper into prevention, we have to be prepared for the litany of meanings and practices that will be opened up.” But as noted above, there are different ways of looking at such impact. One being from an individualistic perspective (“I-sex”) the other from a societal perspective (“We-sex”). This is where a major contradiction comes to light: that of activists fighting in the name of “the community” whilst wobbling on individual issues threatening that community (the “liberal paradox”).

That “Our communities are dynamic, that pleasure is complex, and that there are always unintended results of our efforts” is a matter of fact. That it is time to get our acts together and to stand for what we preach are still words in need of becoming facts.

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