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Barebacking identity among HIV-positive gay and bisexual men: demographic, psychological, and behavioral correlates

Halkitis, Perry Na; Wilton, Leob; Wolitski, Richard Jc; Parsons, Jeffrey Td; Hoff, Colleen Ce; Bimbi, David Sd

Original papers

Objectives: To determine the correlates associated with barebacking identity among HIV-positive gay and bisexual men.

Design: An analysis of data from the baseline quantitative assessment of a randomized controlled intervention study of 1168 HIV-positive gay and bisexual men from New York City and San Francisco.

Methods: Participants were actively and passively recruited from mainstream gay venues, AIDS service organizations, and public and commercial sex environments. Participants completed a computerized quantitative questionnaire assessing their identity as a barebacker, sexual behavior, demographic factors, psychosocial states, perceptions of health risks, and substance use.

Results: Men of color were less likely to identify themselves as barebackers. Men who did identify themselves as barebackers were slightly younger. They were more likely to miss a dose of medication; report drug use (non-injection and injection); exhibit higher levels of sexual compulsivity and lower personal responsibility for safer sex; and report higher rates of unprotected insertive anal intercourse, unprotected receptive anal intercourse, and unprotected insertive oral intercourse with all partners, regardless of their HIV serostatus.

Conclusion: Barebacking and its corresponding behaviors pose immediate public health risks for HIV-positive gay and bisexual men. Further work is needed to understand this phenomenon more fully in relation to the psychological, sociological, biomedical, and cultural realities.

From the aDepartment of Applied Psychology, Center for Health, Identity, Behavior & Prevention Studies, New York University, New York, NY, USA

bDepartments of Human Development and Africana Studies, Binghamton University, State University of New York, New York, NY, USA

cDivisions of HIV and AIDS Prevention, Prevention Research Branch, Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention, Atlanta, GA, USA

dHunter College and the Graduate Center, City University of New York, New York, NY, USA

eCenter for AIDS Prevention Studies, University of California, San Francisco, CA, USA.

Correspondence to Perry N. Halkitis, PhD, Department of Applied Psychology, New York University, Room 537G, 239 Greene Street, New York, NY 10003, USA. Tel: +1 212 998 5373; fax: +1 212 995 4358; e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.