Therapist Dominic Davies suggests 10 reasons why some men take risks with their health.
I’ve identified at least ten possible reasons, often found in combination, why some people take sexual risks and engage in unprotected sex. Greater awareness, understanding and discussion of such factors may help when trying to promote better sexual health, not least amongst gay men.
1. Sensual Pleasure. There is little point pretending otherwise: sex without condoms feels better, more spontaneous and more sensual. There’s no scrabbling around to put condoms on, and you can fuck and swap around quickly, easily and frequently without incurring a huge pile of used condoms!
2. Thrill seeking. Some guys like danger. Condomless sex is like playing Russian Roulette. Other thrill-seeking behaviours include sex in public places and meeting strangers for sex.
3. Depression and low self-esteem. We’re more likely to self-harm and to consult our GP or mental health practitioner than a straight person is - most likely due to external and internal homophobia. Some anti-depressants cause side effects which may in turn lead to sexual risk-taking. Low self-esteem can leave us feeling our lives aren’t worth protecting. Such negative thinking may lead to a sense that HIV infection is inevitable. It can even be a way to manage anxiety around fear of infection: “Once I’m infected I don’t need to worry about this again.”
4. “Real love”. It’s romantic! Unprotected sex can symbolize intimacy and trust for some. It can feel romantic to fuck without barriers as you literally put your life in your partner’s hands.
5. Safer-sex fatigue. Some gay men have become tired of always having to protect themselves. This can lead to abandoning safer sex even after decades of being careful.
6. Disinhibition through drugs or alcohol. When high on drugs (esp. alcohol, or crystal meth) it is harder to remain aware and to maintain one’s resolve always to have safer sex.
7. Peer ‘pressure’: others do it. Scrolling the pages of some cruising websites, one could be forgiven for thinking that safer sex is a rare and arcane practice. The increased frequency of entries other than “Always” in the Safer Sex box contributes to the idea that: “If everyone else is doing it, why do I need to bother?”
8. Denial - I’m OK and he looks OK. There’s a kind of magical thinking that leads some men to think they can see or “just know” that someone isn’t infected or that they’ll somehow remain OK if they occasionally have unprotected sex with someone particularly attractive, young, charming or horny!
9. Rebelling against the forbidden. Some gay men consider themselves outsiders and unprotected sex can be a way to say: “Fuck you, this is my body and I’ll do with it what I want.” The forbidden has more allure for some and unprotected sex is “transgressive”.
10. Calculating risks. Many men are highly informed about the dangers and use a variety of risk reduction strategies. These may include only having sex with people who share their HIV antibody status and test regularly; being the active partner; not cumming inside; having receptive anal sex only with guys who have an undetectable viral load and are on anti-retroviral meds.
There are many reasons why some of us take such risks at least some of the time. It can help to be aware of them. If you are concerned about your risk-taking it can also help to talk to someone. After all, we’re all responsible for our own health and for the health of those we have sex with.
Pink Therapy is the UK’s largest independent specialist therapy organisation working with gender and sexual minority clients: www.pinktherapy.com
Adrian Gillan
