We now live in an age when PrEP gives HIV-negative men and women extra precaution against HIV transmission — a precaution that, according to every statistic available, is more dependable than regular condom use. But while PrEP has the potential to lower HIV transmission rates among the people who can get access to the costly medication, rates for other STIs like chlamydia and gonorrhea and syphilis are soaring among gay men.
I do not shame barebacking because most of my sex is bare and condom-less. I am a piggy guy who loves male bodily fluids — cum, sweat, piss, spit, in that order — but I also know my sex practices involve STI infection. Most clinics and LGBT centers say that sexually active gay men should receive a full-range testing every three months. Since I am having regular bareback sex, I get tested every month, no exceptions.
Getting tested every month is not a preventative healthcare practice, but a responsive one. While I agree that most responsive healthcare regimens are less healthy in the long run than preventative care — our overmedicated society is evidence of that — I concede here that monthly STI testing and PrEP jointly face a present reality: gay men are having bareback sex, and lots of it.
The thinking goes that if you get tested regularly for everything then you will catch STIs and treat them before they become bigger problems (and let’s face it, if you are a sexually active gay man, you are going to get an STI at least once in your life). This thinking does not work so well for HIV, since HIV can stay in the body for months before it registers on an HIV test, during which time the virus is very transmissible. But for men on PrEP who make the decision not to use condoms, monthly testing is the minimum degree of self-care that you should practice.
While bareback pigs frequently incur shaming and anger from people both in and outside the gay community, stigmatizing a lifestyle does little to address its reality. Barebacking is in, and the vast majority of homos I know do it. This fact is probably a nightmare to public health workers and a damning picture of gay promiscuity to sex-phobic and homophobic people all over the world, but neither of those opinions change the fact that many of us (I am tempted to say “most”) are fucking bare and not apologizing for it. So rather than cast blame, the wisest response is for me and every health care worker and conscientious gay man to urge guys who bareback to get tested as frequently as possible.