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Developments in recent years have given rise to a broader perception of Antiretroviral Therapy as all but eliminating infection risk for HIV. There may in fact be a higher risk of transmission if you seek exclusively "HIV negative" partners, as "HIV negative" tends to be inferred from an absence of knowledge. With the absence of knowledge, viral load will invariably be significantly higher in the new infection period before HIV specific antibodies are produced (about 6 months after infection, thus confirming a positive result via routine testing). Factoring in 3 months for testing interval, a partner may have been infectious for 9 months before knowing as much - all the time using the term "HIV negative" in good faith.

In light of this, establishing that your partner is on ART or PrEP is now the best way of avoiding transmission of HIV if high-risk activities (barebacking) are assumed to be taking place. If your partner is HIV+, it will also be useful to establish that he has a recent undetectable viral load or is otherwise negligible and thus virtually noninfectuous. Otherwise, a very recent high-accuracy test such as the RNA test sometimes used in the porn industry may be helpful in firming up a "negative". Even this test still suffers from potential 4-week infectious period before a person tests positive, so when it comes to high risk activities, a partner's drug regime is far more important than their claimed status.

As it is a fast moving topic, barebacking is obviously a controversial issue. As new knowledge comes to light, there is little time for old attitudes to adjust to new realities. The following sections are opinion pieces on a few of the accompanying topics - namely barebacking among male sex workers, culture and sexual deviancy, and the push to publicly fund PrEP as a "lifestyle choice".

ESCORTS ADVERTISING BAREBACKING

Since this page is collecting a lot of the search traffic for bareback gay escorts, I felt I had to justify its existence. I have noticed that despite the obvious prevalence of barebacking, some online directories allow a disclaimer and some don't. None of them, however, are structured to bring about the sharing of information crucial to establishing compatibility between customer and provider - which is often glossed over as embarrassing or inconvenient. This allows a number of misconceptions to take root, such as casual use of catch-all prejudicial terminology such as "clean" and "disease free" in association with escorts offering bareback services. Any male engaged in regular unprotected anal sex can't guarantee that he is negative, and may indeed have a massive viral load if he is newly infected with HIV. Often, this is exactly how HIV is transmitted.

On the other side, there is also a general prejudice surrounding male sex workers who offer bareback. Customers will often refuse to contact a provider on the basis that a he is offering bareback as a service. In reality, any rational decision to offer this service is likely to be coupled with a conscious risk aversion strategy, including regular testing and use of pharmaceutical drugs as a preventative or treatment. You might be surprised just how many sex workers who advertise as safe only will happily go without protection with special customers and random hook ups. They tend to be less aware of risks, active risk reduction and have an all-or-nothing approach thereto, ignoring some of the simpler medical and behavioural approaches to risk reduction.

BAREBACKING AS A DEVIANT CULTURE - Deconstructing fetishisation of the topic

Deviant cultures, by their very nature - define themselves in opposition to the prescribed norms of their time; what is held to be desirable in polite, public discourse. It is perhaps appropriate then, that on the back of gay liberation/assimilation, antiretroviral therapy and sexual health awareness, subsets of the community are feeling the need to form new subcultures that fetishise aspects of identity and "deviant acts". Pederastic homosexuality (chickenhawking) had of course been conveniently ousted from the fold, leaving mainstream gays in an acceptable but boring vacuum. Rooted in the risk and edginess of said "act", the barebacking fetish arrived in good time, and is more akin to a degradation fantasy where the actor's mental awareness of their own deviant desires and behaviours is a crutch for psychological pleasure. I've lost count of the number of times I get asked to perform BB in the heat of the moment in a somewhat crutchy way that has allowed my partner to orgasm after the mere thought. In a strange way, public health awareness campaigns create their own problems by circulating a standard discourse that is ripe for antagonism by those who are attracted to "sexual deviance" and seek to live it out in reality.

"I do it because it feels better" is perhaps the biggest lie told by bareback fetishists (not necessarily all barebackers) to themselves and others. Among homosexuals forty or more years ago, anal penetration would not have been seen as a necessity for either physical pleasure or an invigorating awareness of one's own deviance (for the latter, the mere act of seeking a contact sufficed). Even against the backdrop of our current anal fixation, masturbation, oral copulation, even frottage are often cited by gay men as more "realistic" ways of achieving climax, given the greater level of control over physical sensation and less "dirty" implications. The repeated use of the term "open-minded" in relation to barebacking fetishism is another misnomer (as it is with most party drug use). For one to be titillated by the sheer deviance or risk of an "act", or a fear of guilt, their desire must be underpinned by an inculcation of, or reference to social orthodoxy, in this instance - social conservative norms. Whilst it may be open-minded to entertain a wider range of possibilities, the basis for the fetish itself is a form of narcissism in which body pleasure is erased, and an awareness of one's own deviance and "dirtiness" forms the basis for psychological fulfilment. This can be seen, for example with the popularity of death symbolism in bareback gay porn. I fear that this narcisissm - a focus more on relationships between social identities - archetypes - and the performance of acts, is indicative of a wider problem throughout gay culture and the western world. Children are developing their identities in reaction to dictates laid down by the dominant social/political culture (now a secular form of "evidence based liberal" secularism that masks fundamental, historical social-conservative underpinnings). We witness this alongside the problematisation of body pleasure, stratifying dogmatism of the social sciences, sexological/ medicalising discourse, social identity fetishism/collectivism, etc.

WHO IS PAYING FOR PrEP?

There seems to be a movement among gays and some feminists to use the state as a defacto "Daily Express of Free Shit" when it comes to lifestyle choices dictated by their feelings - including allegedly "superior and unaffordable" brands of sanitary products (the rag!), free condoms and now preventative HIV drugs. The implications of this special pleading on public perceptions of their identity groups (maturity, self-sufficiency?) are of course never taken into account. This is because like a lot of modern awareness raising, identity politics pleading is really a sales-pitch based on what level of extortion is feasible, rather than what is rational, consistent and justifiable.

Still, as can be seen above, I have shared a link to a website where users can gain access to generic PrEP, without prescription, at a significantly discounted price when compared to the in - patent version of the same drug. These drugs basically prevent the transmission of HIV if used correctly. The wider this information is spread, the less the taxpayer will be burdened by the crippling cost of antiretroviral therapy on the NHS (and the ever-questionable symbiotic relationship between arms of government and the pharma industry). Proponents of PrEP as a publicly funded treatment often claim that despite its cost (at the time of writing, approaching X10 the drug-cost before proposed renegotiation), it passes cost benefit analyses - with the benefits being reduced antiretroviral therapy costs down the line. This assumes precedence over other treatments that also pass the cost-benefit, and also assumes that members of society are not, or should not be fully capable of realising the end benefits of this treatment by making their own interventions (at drastically reduced monetary costs). This to me, sounds rather illiberal – given just how much funding PrEP would cost the NHS compared to individual actors - and is the main philosophical reason why I am not for it. Expedience, however - is perhaps a better reason, i.e. that it is simply the wrong time to be asking for this public funding windfall. Whilst PrEP is not specifically a "gay" treatment, it's uptake is strongly biased towards men who seek casual encounters with other men - public perception merely exaggerates this. Whilst the sheer volume of stigma-laden untruths still banded about on the subject of HIV may be frustrating, a clamour for public funding runs the risk of being seen as using the gay card to agitate for special treatment - and may therefore not be expedient at this time. Focus should instead be on the circulation of information - pressure put on governments to produce or permit the supply of much needed, cut-price generic drugs, bypassing the patent-holder pharmaceutical industry regardless of the perceived risks. And if we are to request tax money to innovate and/or produce a life-saving treatment, then surely the way we spend it should be comparable to a subsidised open-source technology rather than a rights-holding corporate model? Perhaps a radical overhaul of the pharma industry is what we should really be asking for.


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