Rise Seen In Unprotected Sex Between Gay American Men

A new study from the Centers for Disease Control and Prevention shows that the number of men who reported having unprotected anal sex within the last year has jumped by 20% between 2005 and 2011, The New York Times reports:

CdcThe data, published in the agency’s Morbidity and Mortality Weekly Report, do not explain why unprotected sex has risen so rapidly, but a leading hypothesis, Dr. Frieden said, is that more men are “sero-sorting” — that is, those who are uninfected (“H.I.V. seronegative” on lab reports) try to sleep only with other men who are uninfected, or who hope they are, or who merely promise they are.

“The problem with sero-sorting is that it’s really easy to get it wrong,” Dr. Frieden said. “When one-third of men aren’t even tested in the last year and a tenth of those who thought they were negative were actually positive, you don’t want to risk your life on a guess.”

Other hypotheses, say Dr. Frieden and Dr. Jonathan Mermin, the disease centers’ director of H.I.V. prevention, are that many young men have never known anyone dying of AIDS and so do not fear it, or that they believe that they can easily stay on antiretroviral drugs for life.

Two leading independent AIDS researchers agreed only partly with those explanations.

“Young guys are less worried,” said Alex Carballo-Diéguez, a researcher at the H.I.V. Center of the New York State Psychiatric Institute and Columbia University who has studied gay men’s behavior since the 1980s. “H.I.V. has become a chronic disease, and everyone knows some behaviors are bad for you, like smoking and trans fats. But in the moment of excitement, they’re going to do what they enjoy.”

Perry N. Halkitis, a researcher at New York University, meanwhile suggested that the rise in unprotected sex between gay American men can be attributed to two factors: the decreased transmission risk when sleeping with an HIV-positive person who is taking daily antiretroviral medication and the collapse in the economy which left many young men out of work, “and we see higher-risk behavior when people have more risk in their lives.” Halkitis cautions that though antiretroviral medications do significantly reduce the risk of transmission, not all men on the drugs take them everyday thus reducing their effectiveness.

The report from the CDC comes as a new aggressive strain of HIV, A3/02, has been discovered out of Guinea Bissau in West Africa, Al Jazeera reports. The new strain is recombinant, meaning that it is formed when "two of the most common strains in the region fuse together." A3/02 appears to descrease the time it takes for a person to develop AIDS once infected with HIV:

Guinea"Individuals who are infected with the new recombinant form develop AIDS within five years," Angelica Palm, one of the scientists involved in the study, said on Thursday.

"That's about two to two-and-a-half years faster than one of the parent [strains].

Research shows that recombinant strains, those created when different DNA combines, are a cause for concern.

"There have been some studies that indicate that whenever there is a so-called recombinant, it seems to be more competent or aggressive than the parental strains," Palm said.

You'll recall in October we reported on a similarly virulent strain of HIV that has emerged in Russia. Like that strain, A3/02 does not appear to be more deadly or resistant to treatment. In other words, existing medications will still fight A3/02. 

Researchers meanwhile are still searching for ways to target and destroy the HIV virus. While an HIV vaccine still appears to be a ways off, European scientists have come up with a model that could target and destroy the AIDS virus within a human body by preventing the virus from replicating, according to io9:

European researchers have used a computer to design small synthetic molecules capable of attacking the deadly AIDS virus where it hurts the most: its ability to produce the genetic material required for replication. It's the first time in history this has ever been done…

The novel designer molecules work by blocking the virus' ability to replicate. And they do so by inhibiting the output of genetic material from the infected cell nucleus to the cytoplasm. Without replication, no new infections can occur. So in theory, because all cells are mortal, even the infected cells will eventually wither away and die.


  1. QJ201 says

    barebacking, serosorting, crystal meth, etc., etc., etc.

    We’ve been reading these reported for OVER A DECADE.

    NEVER leads to any NEW public health promotion aimed at gay men, just some talking head reminding us to “use a condom everytime.”


  2. Lars says

    @QJ201: allow me to be one of those ‘talking heads.’ Why do we need some new/clever/sophisticated campaign when the message is really, REALLY, simple? Always use a condom. Done. No exceptions, no ‘what ifs…’ No ‘But we’re exclusive!’ None of that crap. This one is really easy, guys.

    In the year 2013, there are only two primary reasons our gay brothers are still getting infected 1) Recklessness, and 2) Ignorance/misinformation. The first one, to a certain extent, can’t be helped. People are always going to be idiots. It’s why plenty of us smoke, don’t wear seat belts, and engage in a host of other activities likely to harm or even kill us. The morons will always be with us (until their stupidity causes them to take their leave).

    But as to the second reason, the ignorance/misinformation, it is essential that we hammer away at that one simple refrain: Always wear a condom. Always. It is incumbent on all of us to tell our stories, to explain why it is so important to be safe, to explain why HIV is still dangerous, debilitating, expensive, and stigmatizing. There is no reason to complicate it with some fancy new campaign.

  3. Chris says

    It’s due to the increase in bareback porn. That’s where most gay men first learn about how to have gay sex. How many gay men use condoms for oral when gay porn used to have condoms for anal sex? Now that gay porn doesn’t use condoms for anal, gay guys are not learning to use condoms for anal either.

  4. Merv says

    After all these years, we still don’t take HIV seriously. I’ve known that for a long time, which is why I stopped having sex in 1993. It was the best decision I ever made.

    Even universal condom use is not enough. Combine condoms with universal use of home HIV tests and we’re starting to approach acceptable risk levels. Despite their serious limitations, home HIV tests are the best thing to come along in years. Those who have been falsely passing themselves off as negative can finally be exposed.

  5. Paul R says

    Even if you’re not purely monogamous, you can still be safe. I was recently in a relationship for 19 years, but after 10 he and I started having both exclusive and combined dalliances every year or two (never the same guy/s for more than one night) and were always safe. We never had a problem. It wasn’t an open relationship as such, given the rarity of our “transgressions,” which were always known to and approved by the other. I’ve known people in supposedly monogamous relationships who lie about everything. Our approach was far healthier. And I know that our approach was hardly rare.

    The notion of sero conversion and “bug chasers” is beyond me, but so is a lot of the gay world fringe elements. I also think those behaviors have been exaggerated. So count me a skeptic of the study’s universal applicability.

  6. sassyboy says

    I think it’s unfair/unrealistic to expect gay men in monogamous relationships to use condoms–something not required of straight couples. By monogamous, I mean exclusively dating for 2+ years (not some trick you’ve been hooking up with for 2 weeks).
    When my bf and I decided to be exclusive, (going on 8 yrs now) I told him if he ever decided to cheat on me that he should use a condom. It’s a tough conversation to have; no one wants to be cheated on but better to be safe than sorry. I think its the moral and ethical thing to do.

    The one caveat I will add is that if you’re dating some with drug/alcohol problem/lives in the circuit scene be very careful and always use protection since people with substance dependence issues are not the most rational folks.

  7. beergoggles says

    The survey makes no mention of several developments over the years. There’s no mention of monogamous partners. There’s obviously going to be a change in practices after marriage has become legal in multiple places.

    There’s also no mention of those practicing PrEP or PEP.

  8. stevetalbert says

    I fault the organizations that glamorize being positive asvif it is something good. HIV Is Not like type 2 diabetes or asthma or something.

    30 years of a preventable disease is about 20 years too long. Everyone knew by the early 1990s what it took to have high chance to stay negative. Anyone getting hiv after that time wanted to get it. No matter how people feel about the issue, that’s a fact.

  9. stevetalbert says

    I fault the organizations that glamorize being positive asvif it is something good. HIV Is Not like type 2 diabetes or asthma or something.

    30 years of a preventable disease is about 20 years too long. Everyone knew by the early 1990s what it took to have high chance to stay negative. Anyone getting hiv after that time wanted to get it. No matter how people feel about the issue, that’s a fact.

  10. Sargon Bighorn says

    Don’t you get tired of telling other people how to or how not to have sex? I sure know that many young hip trendy popular Gay men don’t want some “Old Man” telling them how to live. Be your own judge of your own life. HIV exposure is no longer the result of ignorance, lack of knowledge about transmission, or effects on the body.

  11. jamal49 says

    Is it only gay men? Or, can we also conclude that these new strains are infecting heterosexual people. This constant identification of HIV with gay men only must stop. HIV infects anyone and in Africa and places like Venezuela and Dominican Republic, for example, HIV infections are primarily male-to-female transmitted. Regardless, and considering that the incidents of HIV infections have risen once again among gay men in the U.S., one wonders just how goddamned stupid some gay men are when it comes to having unprotected sex with a stranger. Pretty goddamned stupid, it seems.

  12. Anonymous says

    Sorry gang – but while condoms are a good health policy, they just aren’t as good as raw sex – natural sex. Tell everyone to wear black plastic bags to the beach to avoid skin cancer. It would work but no one would do it. This is where straight white male scientists sit in a room and come up with sound policy they don’t have to live with. There are nearly no real research on undetectable viral load men having sex with men – or on better condoms that don’t feel like your wearing a raincoat to the swimming pool.

    My husband and I are poz since the early 90’s – will never wear condoms – which hasn’t led to any superstrains or limbs falling off. We are tired of 20 years of campaigns that have at their core the poz man as diseased parrhia. Spend some money on sex positive research that improves gay sex and we’ll listen – otherwise these articles sound just like Michelle Bachman promoting tired old religion as politics. We are mostly monogamous but occasionally will sleep with hot poz men.

    And to the comment on “preventable”. – yes if all gay men would just deny their humanity and just be celibate there would be no HIV. Or if only everyone would be happy with second class secs – or never got drunk – if only life were a perfect little bubble ther would be no skin cancer, no lung cancer, no hpv – and absolutely not worth living.

  13. Anonymous says

    I particularly love where folks seek reasons – it’s the gay porn – it’s serosorting – it’s mercury in saturns ascendency. Ummmm it feels 100000000% better? Um maybe that? Hey – why did the starving man die? The flapping of a butterflies wings in Texas – or – he had no food.

  14. Derrick From Philly says

    I don’t care what all you “safer” sex Pollyannas, say but one condom ISN’T ENOUGH! If you wanna play nice, wrap it twice! Also, both condoms should be soaked in bleach and extra-triple-duty spermicide overnight prior to reuse. You can never be to careful, ’cause it’s a jungle out there!

  15. jjose712 says

    I never understood why people is so irresponsable. Of course you can have an accident and your condom broke, or something like that, but most people infected just don’t take their health seriously.

    And some people even glamourize the illness, something that it’s beyond me

  16. says

    I have a news flash for some of you: guys are NOT going to wear condoms if the don’t want to. I’ve been a HIV/AIDS advocate for more than two decades and we can hammer away and deliver sermons all we want on condoms.

    Go ahead and try; I’ll wait right here while you do.

    And then we both can go through my email box and read the client emails I get about guys who’ve just seroconverted. They were drunk, high (fill-in-the-blank) and weren’t thinking. There is no amount of “always wear a condom” messaging that’s going to change that behavior, and I’ll pit my boots on the ground experience against your armchair quarterbacking anyway.

    Should guys always wear a condom? Sure. Will they? No. Which is why any HIV/AIDS educator out there is polishing and honing their PrEP message. They’re educating guys out there how to PROPERLY serosort and when it will and won’t work. Nobody is sticking to the “always wear a condom” mantra as the sole message of hope because that ship has long since sailed. They’re talking about their own experiences on PrEP and educating others that this 30 year old model of no condom=automatically unprotected is long overdue for an overhaul and there are ways to protect yourself in addition to condoms.

    Times have changed. The message we delivered three decades ago has to evolve or our AIDS history of the 80’s will repeat itself

    –end rant–

  17. andrew says

    Another cause for the rise in unprotected sex among gay men is the influence of gay porn. In the last year or two even the classy gay porn Studios like Sean Cody, Corbin Fisher and Bel Ami have been increasing their production of Bareback and “Condom Free” sex scenes. These Studios show physically beautiful and muscular young guys engaging in BB sex. It desensitizes some to the danger and ugliness of HIV infection. Look at the world of advertising and see how watching what beautiful people do influences the behavior of others.

  18. Randy says

    I’m not going to judge anyone for bareback sex, when we’re (almost) all here due to bare sex.

    But we’re not going to solve this with new drugs. Reducing the number of sexual partners, and aggressively promoting masturbation (yes, even the Surgeon General) is probably the best way.

  19. Neil says

    “Does this number include men in monogamous same-sex relationships? Because it could be overlooking something significant…”

    @John B., it’s worth noting that up to 2/3 of new HIV infections come from couples, according to recent stats.

  20. stevetalbert says

    All the excuses still don’t change the fact that HIV is 100% preventable, and people engaging in whatever type of sex they consider “safe”, “safer”, or “unsafe” have to deal with the consequences. Same thing with STDs from blow jobs or crabs or colds from kissing. Life is messy. That doesn’t excuse the people who are putting others at risk by having anal sex without a condom (basically the main way to get HIV). Regardless of how “consenting” everyone is.

    We are all going to die of something sometime, but HIV and/or being positive doesn’t need to be glamorized like it is. This isn’t going to change until we have a generation or 2 of gay people growing up with positive self images that they deserve more than “nasty sex and getting HIV”. I’m certainly not for HIV colonies like lepers, but I definitely won’t give any more money to a worthless cause. Too many other people in need of basic shelter and food who actually care about themselves.

  21. JB says

    New Zealand is seeing year on year REDUCTIONS in HIV infection. Reasons – a good social healthcare system but more importantly an ongoing Gay run (NZ AIDS Foundation) education program that has stuck to the “CONDOMS = Safe Sex message” that works! While other countries have been distracted onto campaigns for “negotiated safety”, “blood donor “rights”, “treatment = safe” etc.


  22. GregV says

    “…it’s worth noting that up to 2/3 of new HIV infections come from couples, according to recent stats.”

    @Neil: If that stat is true, it is worth noting, but it’s also important to note whether that stat refers to people who are NOW a couple who had HIV before the fact. It’s also important to subcategorize the couples.

    HIV-negative monogamous couples may need to wear condoms for OTHER reasons, but HIV protection is not one of them.

    Like JohnB, my first thought was about monogamous, long-time-tested-as-negative, monogamous couples. If anal sex without a condom has increased only in those couples and has decreased among everyone else, then the risk overall would decrease.
    Still, considering that frustrating fact that the number of infected people continues to increase every year, it is a fair assumption that too many people are continuing this dangerous behavior with people whose status they either don’t know or whose status they do know to be positive.

  23. andrew says

    @Derrick from Philly: DO you actually soak your condoms in bleach before using them? You might want to check with your primary care doctor or some HIV/Aids specialists about this practice. To a layman like myself, it sounds like you are destroying the protective quality of the condom, not to mention the irritation it must cause your penis or anus.

  24. Derrick from Philly says


    No, that’s not me. And this isn’t my type topic to comment on.

    It’s Rick. And he’s silly

    LOL…nowadays the only condom I’ll come in contact with is on a rubber toy. LOL

  25. northoftheborderguy says

    I can’t believe I’m reading some of these comments. I’m pos. I never knowingly had unprotected sex. All you losers out there who say that anybody who is pos is at fault should give your heads a shake. Some of us are still in shock at being diagnosed as having HIV. I didn’t go out looking to get infected. How dare you suggest otherwise.

  26. says

    @LARS: You can say “always use a condom” till you’re blue in the face but the fact is that the CDC found that only 16.4% of gay men manage to use them truly consistently over a 3-4 year time period. See http://www.aidsmap.com/page/2586976/#item2586982. I don’t think that’s telling us that we haven’t been consistent enough in our messages. I think it’s telling us that maintaining condom use is *difficult* and we therefore need more alternatives. Condoms are great because they also protect against other STIs but they are not enough and by saying “use a condom every time” you are condemning gay men to an insufficiently protective strategy.

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