Hooked Up: Exploring HIV Disclosure Online
September 28, 2013
Some hook-up sites for gay men make it easy to discuss HIV status; others just muddy the waters. But how reliable is the data for deciding what sex to have, with whom and how safely? And how does barebacking fit in? Bob Leahy looks at two popular sites and arrives at some surprising conclusions.
How much do we know about disclosure on the internet? Not much if we look for published research on how guys communicate for sex in 2013 or how frequently they reveal their HIV status in a meaningful way or even how guys use their profiles to get what they are looking for.
And how often does reliance on the efficacy of profiles put negative guys at risk? We just don't know. But in an age where HIV researchers have seemingly studied virtually everything that moves, the most popular way in which gays hook up and its sexual health implications seems largely overlooked. So we must rely a lot on what we observe ourselves and on other empirical evidence.
In any event, to gain a broader perspective, I looked at how disclosure issues play out on two busy sites popular with gay men -- Squirt.org. and BarebackRT.com. Both have tens of thousands of users, are free for the basic service but charge $13 or so a month for a package of more advanced features which make hooking up smoother.
I decided to look at a manageable 32 random profiles from each site, using in each case a Toronto-based sample, in part because the rate of HIV infections, and arguably propensity for disclosure, is high in gay men there. It is also a place where the chance of poz and neg guys interacting sexually is higher. The result is a survey which lacks scientific rigor but nevertheless sheds some light on how we tackle disclosure online and whether that process appears effective.
Squirt is owned by the same folks that bring you the LGBT paper and website Xtra! Based in Toronto, it's got a huge number of members from around the world, and includes lots of video content that users have provided of themselves in action, plus the usual stack of photo images. Some of these are locked and access has to be requested directly from the user. Thus the identity of a user can be well protected unless he chooses to identify himself by way of face pictures and the like.
Camming is also popular on Squirt.
A key problem with Squirt from a sexual health point of view is that it does not have a field which permits users to state their HIV status: instead it asks members to indicate whether they practice safer sex always, usually, never or rather not say. None of this, of course, is particularly helpful.
On to who is on it. Of the sample of 32 Toronto-based members whose profile was reviewed, no less than 25 indicated they "always" practiced safer sex. Does that jive with what we know about how often men who have sex with men dispense with condoms? Not at all; statements like these may be pure window dressing or more charitably, reflect men's intentions rather than their actual practices. In any event, of the seven who indicated they did not always practice safer sex, five indicated a specific interest in barebacking. One member of the 32 indicated he never practiced safer sex.
But how do you define safer sex?
Only two out of the 32 (both checked "usually" have safer sex) mentioned poz guys in the list of the kind of men they preferred. There was some stigmatizing language throughout the profiles of those who "always" practiced safer sex, with more than a few instances of men seeking "clean" partners. Many poz men find the use of that word derogatory.
It's not surprising that in this kind of environment it is not hard to find examples of both stigma and lack of sexual health education. One Squirt member provided evidence of both in this exchange between a positive top (him) and a supposedly negative bottom.
Top: Check out my private photos. Click here to see them.
Bottom: Yes, I would love to swallow your cum
Top: love to have that happen but I'm poz/undetectable. It's safe but is my status a problem for you?
Bottom: Maybe you can just suck me then. I am almost 7 cut, clean and safe.
Oy vey! Poz guys require a thick skin if they are to declare their status in chat once contact has been made. The general consensus is that outright rejection after a negative man has initially shown interest is in the range of 50%, however safe the sex contemplated.
Searching for something special? Squirt can help you. While Squirt is hardly a bareback site, but leans perhaps towards the vanilla, poz users can search for others seeking poz guys or those looking for barebacking, as an example.
And barebacking certainly seems popular. A search of all Toronto member profiles indicates no less than 2,017 members seeking barebacking opportunities. Given we do not know their status, it's hard to know whether these are mostly poz guys seeking poz guys, neg guys seeking poz guys or perhaps includes neg guys on PrEP who consider themselves not at risk.
All this speaks to a minefield, where the status of one's Squirt partner may well be a mystery until further online or in-person discussions occur, if at all. For poz guys wishing to serosort, though, there are opportunities to do so but the site is not particularly well suited to it. It thus may well be that such poz guys are better suited to a site geared to barebacking, if this activity is sought, one that handles disclosure of one's status a little bit less enigmatically than Squirt would. So ...
Brace Yourself for BarebackRT.com
A quick look at BarebackRT.com (BBRT, the world's largest and busiest site for gay men seeking bareback sex) reveals it's both more detailed in terms of describing each of its members and what each member is seeking in others. From a sexual health perspective, as well as a measure of how effective a site is in connecting like-minded guys, that isn't a bad thing.
It's also very raunchy. Combined with a clean design and nice functionality, the site is an impressive one.
One anonymous poz member told me:
The thing I like best about BBRT as a hook-up site is not necessarily the most obvious one -- a place to meet guys into bareback sex. Rather, for me, it's a place where, as a person living with HIV, I can serosort and find other poz guys to have sex with without the stigma and discrimination I find on other hookup sites or apps like Grindr and Scruff.
I think it's great that I can identify my status as either "positive" or "undetectable" on BBRT and say whether or not I'm looking for other positive/undetectable guys.
The same member added: "I also think it would be great place for HIV negative guys, for whom condoms don't work, and who want to lessen their chances of getting HIV by hooking up with poz guys with undetectable viral loads. Counter-intuitive, I know, until one remembers that someone with an undetectable viral load (and who doesn't have any STIs) is unlikely to pass on HIV to their sexual partners."
BBRT members, as the name implies, are almost exclusively seeking men willing to bareback. The site helps men narrow down the field; rather than merely specifying you are a top or a bottom, for instance BBRT will let you say whether you give and/or receive loads orally and give and/or receive loads anally. It will allow you to indicate your preference as to the HIV status of your partner and that of yourself. And as the above member says, you are able to check that you are undetectable and/or looking for undetectable partners. That, incidentally, is a well used option.
So on to the survey. Sampling 32 Toronto-based randomly chosen BBRT profiles can be distracting. BBRT profiles are frequently explicit and so are the user pics accompanying them. Nevertheless we soldiered on ...
Looking at HIV status, of the 32 profiles sampled, 13 members indicated they were undetectable, another three indicated they were positive. Twelve did not specify and five indicated they were negative. (Negative?)
Why, one might ask, unless they wish to seroconvert, and that's generally deemed rare, are negative men looking for bareback sex on a site like this? Four explanations come to mind: a) they are on PrEP and feel this provides adequate protection, b) they are neg and seeking other neg guys, by any measure a risky harm-reduction strategy, c) they don't mind if they ultimately seroconvert, or d) they are savvy neg guys seeking out poz guys with undetectable viral loads, who many deem incapable of transmitting the virus.
Superficially, it does seem that more than a few neg BBRT members want to be "seeded" or to be "bred," barebacking language sometimes indicating a wish to seroconvert at the hands of a poz top. How much of this is fantasy has always been a matter for academic debate. Clearly most men here though, poz or neg, are looking for condomless sex, plain and simple. For most, we know, they do so because it feels better. Research shows us in fact that most poz barebackers have no interest in infecting others. (For a detailed exploration of barebacking culture, refer to my interview with Unlimited Intimacy author and barebacking expert Tim Dean.
Notable too is that stigmatizing language, other than it relates to age/body-type preferences, seems virtually absent from BBRT. There is no "I'm clean, UB 2" here or the much hated term "DDF." A further plus is that in enabling poz members to record their status on the site, this feature reduces the possibility of subsequent prosecution for nondisclosure.
Conclusions: Vanilla vs. Hardcore
It's hard not to argue that sites which facilitate guys sharing who they are and what they are into, including serostatus, represent a healthier environment than where that information is handled in a circumspect manner, relying in part on mutual assumptions of status which can often be flawed. Having said that, online banter is not the be all and end all of opportunities for disclosure; many will feel more comfortable doing so, if at all, at other times and places.
At the same time it's inevitable that HIV stigma prevents many gay men from comfortably disclosing their status on their profiles, even where there is considerable licence to do so. There is no doubt too that some poz members, at least on the vanilla sites, will see and experience stigma on these sites through unkind words and rejection. There is also evidence of ignorance of what is safe and what is not, as in the conversation I quoted on Squirt.
It may be the case that online sites can make risky sex more available, but hot sex more available too. As one neg man who uses BBRT, talking about seroconversion, told me "If it happens, it happens. But I'm thinking that's not very likely if a guy tells me he's undetectable -- and he's not lying."
And there's the rub. While disclosure on profiles can work well in making more informed risk decisions, it's not without its flaws. How does a negative guy know he is really negative? And how does a negative guy know his "negative" partner isn't positive? The system is by no means perfect.
Having said all that, a site like BBRT, though likely frowned upon by many -- barebacking remains highly stigmatized whatever the circumstances -- arguably serves a valuable purpose in helping men who would otherwise have difficulty in disclosing do so in a protective environment which (mostly) preserves their confidentiality, helps to reduce risk of transmission and facilitates more worry-free and unencumbered sexual encounters. Thus while the more vanilla of the two sites referred to here, Squirt, seems relatively innocuous and BBRT the place for risky, raunchy sex, one could argue that it is features in the second of the two that contributes to fewer new HIV infections.
Said one profile-savvy negative guy who uses both sites, "I prefer the way BBRT handles HIV disclosure issues; I like the straightforward specificity of their profile form. It makes it much easier to assess any risk factor. There's nothing vague about it ... I respond to honesty in people and I'm much more likely to respond to the profile of someone I feel is being straight up with me and I think BBRT has made that easier for people to do."
Barebacking, like it or not, has come of age at this stage of the HIV epidemic -- more and more people are doing it and many of them pretty safely. Sites which contribute to the safety of an activity which many find irresistible -- not to mention extremely hot -- can only be applauded.
This article is adapted from a piece that originally appeared on PositiveLite.com.
Follow Bob on Twitter @ruraltweeter.
Read Bob's blog, Northern Lights.
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