Without Condoms: Unprotected Sex, Gay Men and Barebacking

If you work with gay men as a health care provider, especially as a psychotherapist or health department prevention case manager, this book is a must. It is directed at professionals, and is quite scholarly, with thirty-three pages of references. However, the fact that the author talks about his own experience as a clinical social worker in private practice, and also the fact that he, himself has HIV, makes the book all the more compelling. It is extremely thorough (with one exception), and explores, in depth, the many reasons that gay men choose to have sex without condoms. The conclusion is that there is no simple answer, and clinicians need to individualize their assessments. No broad brush can put the crystal meth party boy in the same category as the committed couple who stop protection. "Barebacking" can be too easily demonized. The bare, unvarnished fact is that the majority of gay men are not 100% safe, 100% of the time. As health care workers we must be realistic, and look for other interventions besides, "Just say no". In this vein Shernoff discusses the "harm reduction model", offering very specific suggestions. Our challenge is to accept our clients where they are, without condemnation, if we are to truly engage them in a process of change. At the same time we must acknowledge it can be a challenge to witness what seems to us to be provocative behaviors. Shernoff explores his own reactions to his clients' confessions, and how he deals with them; encouraging all of us to do the same.The one exception to this extremely thoughtful and in-depth examination has to do with Shernoff's cursory treatment of sex addiction. He devotes less than a page to the subject, and describes it as "controversial" and "based on a heteronormative concept". Sorry, I beg to differ: it is based on an addictions concept. If you substitute "sex" for "alcohol" in the criteria for alcoholism, the many parallels are obvious. In no way does this mean that the sex gay men have, even in a casual context, is a sex addiction, just as a gay bar patron is not necessarily an alcoholic - but in some cases both meet the criteria of addictive behaviors. The significance of this is that groups such as Sex Addicts Anonymous and the 12-Step process can offer significant support for alternative ways to cope with life, and better choices for harm reduction. For more information the interested reader can get another perspective from Robert Weiss's book, Cruise Control: Understanding Sex Addiction in Gay Men (LA: Alyson Books, 2005).This, however, is a very minor drawback to an otherwise exhaustive examination of the issues. I have worked in this field since the beginning of the AIDS epidemic both as a private therapist and health department consultant. Even with an extensive background and experience this book had much to say to me, and much that I could apply to my own practice. If you work in a related field, this should be required reading.Michael E. Holtby, LCSW, BCD

This book is overpriced for a Kindle book. Someone needs to re-evaluate the cost and adjust. Might sell more is the price was lowered.

Everyone knows that barebacking has been on the rise since the late nineties and how drug use, especially meth, in our culture, along with bareback pornography and the fact that AIDS coctails has led many of us to engage in unsafe anal intercourse even though AIDS is still very much lurking its ugly head around. I personally have watched in extreme fascination when I have visited varipus cities and gone to bath houses or saunas and watched men engage in unsafe sex. To me the most disturbing scene I have ever witnessed was watching a 21 year old going to a bath in Montreal two years ago. i had met him in the hall way upon his entering the building. I was really impressed with his black hair, blue eyes and his beautiful body. We were taking later in the bathroom and he confided in me that it was his birthday and that he wanted to be "bred" by as many men as he possibly could get. In about 30 minutes I watched with absolute amazement this young, beautiful man lying in a sling as man after man performed intercouse on him. Yes, I was turned on by the scene, but even more shocked that someone would want to engage in such a dangerous act. The scene went on for ours and inally around 4:AM I saw the young man again near the shower and he excitedly told me he "had" over 40 studs that night. I ended up leaving the sauna, never to go back to one again, and found this book, "Without Condoms..." and read it in one setting. As a gay guy I wanted to know that why in 2010 would anyone want to risk their health by practicing unsafe sex, not just with one partner, but with multiple men. To me it was almost like this young man wanted to become infected with HIV. After reading this book my questions were answered in abundance. The author, who is HIV himself, writes about why gay men bareback, the issues of drug use and how that has led many to endanger their lives as their barriers are down while having sex and how gay bareback porn has also played a role in barebacking. A book that was written for doctors who are AIDS specialists and therapists, "Without Condoms..." offers people an insight and an understanding as to why barebacking has now reached dramatic heights and how we as a society can deal with it and how we can somehow prevent the sprad of HIV. Obviously what we have beem doing over the last 30 years as far as HIV prevention is not working. What we need is a cure plain and simple and if one if not found soon there will be terrible consequences for all.

This book, dating from about ten years ago, takes a psychological view of barebacking and the reader is left in no doubt that it is a bad, naughty, nasty thing to do. Pathological even. The fervent belief on which the book stands is that any gay man who doesn't use condoms for sex needs to be counselled to within an inch of his life. It takes little notice of the idea that some gay men don't consider the anus to be an erogonous zone, or that others prefer to use toys. Keyword: judgmental.

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