Note: This article was originally written in 1998. Since then, many of the links the author included have become unavailable. Rather than edit material from this work, it is being presented in its original form, with notations to the links added where appropriate.

Michael Scarce is a contributing writer to POZ magazine.


This is not a set of HIV prevention guidelines.
Intended only for gay men who have already decided not to use condoms for anal sex, some advocates believe these strategies may help reduce the harm associated with barebacking. Here, harm should be interpreted more broadly than HIV infection; these tips may also help reduce the risk of other STDs. And bear in mind that much of this info is anecdotal and debated by researchers.


Dilated blood vessels in the rectum caused by sniffing poppers make it easier for viruses to enter your bloodstream, so if your partner ejaculates inside you, you’re wide open for infection. Viagra works similarly and poses similar risks by increasing blood flow to the pelvic region, facilitating erection, and to the rectum.


Use it generously to help prevent tears that allow infection. Don’t rely on saliva. Nonoxynol-9 may afford limited protection against some STDs. However, it may irritate and increase the urethral or rectal tissues’ susceptibility. One study of N-9 use in gay men’s rectums found it did not create irritation that would significantly increase risk of infection, but medical literature yields conflicting data on this. An over-the-counter contraceptive gel, like Advantage 24, is unlikely to fully coat the rectum and provide complete protection.


Early withdrawal before ejaculation may reduce risk. But since HIV and other infectious agents are in pre-cum, this method still poses a risk.


Rationing barebacking over time limits the number of exposures and sex partners – which can reduce the risk of harm-and allows time for healing of tears or trauma in the rectum, urethra and outer skin of the penis.


Try to talk with partners about STD status, including HIV, herpes, hepatitis and human papilloma virus (which causes anal and genital warts). If talk isn’t part of your sex, you may be able to see or feel warts, lesions, discharge or other physical signs of STDs. Be aware that one may be asymptomatic yet still infectious. Decide ahead of time if you’re willing to cum in your partner or allow him to cum in you, then assess your ability to trust your mutual adherence to that agreement.


Douching or using enemas with harsh detergents can strip away protective cells in the rectum. If you use an enema before sex, try warm water. Be careful not to create tears inside or around the anus. Some believe lubes, especially oil- and silicon-based, can trap germs against the skin, increasing likelihood of infection. Douching with a spermicidal foam or homemade vinegar-and-water solution after sex may render some infectious agents inactive, but little research has been conducted in this area. If you are having sex with multiple partners over a short time, don’t douche until after the last one. Try to urinate right after sex: Urine’s acidity can help clean out the urethra.


The more stressed, under the influence of alcohol or drugs, tired or ill you are, chances will be higher that an exposure results in infection. If you have HIV and another STD, you are more likely to transmit HIV. If you’re HIV negative and have an STD, you’re more likely to become infected with HIV if exposed.


Get vaccinated for Hepatitis A and B. Barebacking exposes you to fecal matter and other Hepatitis-transmitting fluids.

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