Gay men versus condoms. Where are we at?
When it comes to having sex, condoms can be the elephant in the room.
They might offer protection from some sexually transmitted infections, but for many people they are increasingly seen as unnecessary and a bit of a buzz kill.
In the heat of the moment, it can be a bit awkward to have a conversation about whether or not condoms are part of the deal. We’ll try and give you the information and the options here.
Should I be using a condom when having sex?
Paul seems quite insistent when it comes to whether or not to use condoms with new partners. “It’s just a given – no condoms, no sex.”
“More often than not, there’s no conversation…” explains Paul, confirming that he ensures he always has condoms with him. “I use condoms with all new partners, to protect against STIs.”
Tony is a little more indifferent about how condoms feature in his sex life. “Sometimes yes, sometimes no.”
Tony is single and likes using condoms with guys he hasn’t met before, but will have sex without condoms with more regular partners.
“I’m mostly top and tend to initiate the conversation…” explains Tony. “As part of that conversation, I’ll talk about being on PrEP and my STI testing history. I’ll encourage them to do the same, so we can agree what we want to do.”
Like Paul, Tony also brings his own condoms when meeting up with guys. However, Tony confirms that there have been times when the other guy hasn’t been on board with the idea of using them.
“I stopped putting my PrEP status on my app profiles at the beginning because people assumed that meant I wouldn’t use condoms…” says Tony. “But my initial motivation was to take the fear out of condom sex.”
Tony explains that before being on PrEP, he had anxiety of HIV even when having sex with a condom.
He also says that he and his partner might have agreed to using condoms before meeting up, but then they might change their minds in the moment.
“I take condoms when I go to a sauna, where multiple men might fuck me…” says James, sharing his experiences. “I insist on condoms being used there. But I have a fuck-buddy that I don’t use condoms with – he fucks me bareback, because we know each other.”
However, James admits that he sometimes bends his own rules.
“There was a bathhouse encounter when I didn’t use condoms…” admits James. “I hooked up with this guy and I was really attracted to him, so I let him fuck me without a condom. I know it goes against my rules, but occasionally most of us give in or change the goalposts. It has happened a few times. I’m more likely to not mind if a guy insists on bareback when I’m using cocaine – an obvious drug to lose inhibitions. I’ve had unprotected sex on cocaine over the years.”
Are condoms just about avoiding STIs?
Sometimes the reasons behind using condoms are much broader than just being worried about getting an STI.
Tony says he has had reactions to several of the antibiotics used to treat bacterial STIs in the past, so even though some STIs are treatable, he uses condoms because his treatment options are limited.
“Also, without being too gross, condoms are a good idea if the bottom hasn’t had time to prepare himself…” adds Tony. “Quite the boner kill to experience that without a condom.”
James says that his decisions around condoms are also linked with pleasure. “I don’t mind the sensation of being fucked by a guy in a condom, but I do feel slightly frustrated by not receiving the other man’s cum.”
What do sexual health experts think about condoms?
“Condoms, in some form or other, have been used for hundreds of years as an effective way to prevent HIV and other STIs such a Chlamydia, Gonorrhoea and syphilis…” explains Dr Jake Bayley, sexual health doctor.
“Since the AIDS crisis in the early 1980s, condoms have formed the central part of most HIV prevention strategies. More recently, we now also have the combination of treating people living with HIV so they cannot pass on HIV (U=U), post exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP).”
While Dr Jake says that condoms are the most cost-effective way for men who have sex with men to prevent STIs, including HIV, he agrees that using a condom during sex is sometimes easier said than done.
“There are a myriad of reasons for some men not using condoms…” says Dr Jake. “These might include difficulties around condom negotiation with partners, drug use in a sexualised setting leading to impaired ability to assess risk of HIV, and erectile dysfunction.”
Will I look weird if I suggest using a condom?
“Never have the sex you don’t want…” advises Paul, who thinks that if somebody wants to use a condom during sex then they shouldn’t feel pressured into not doing so.
He says that being confident in the moment is also important, as well as sticking by your decision. “If you want to use them and he doesn’t and it’s a deal-breaker, fine, stick to that if that’s what you want. There are plenty more fish in the sea.”
Confidence is also something that James and Tony think is important when expressing whether or not you wish to use a condom.
“Talking about what happens in bed is sexy!” says Tony.
As somebody who takes PrEP, Tony advises people to not assume that just because somebody is on PrEP doesn’t mean they don’t wish to use condoms.
“Just be clear about your personal rules, be up-front, ideally before you meet up…” says Tony. “Also, be prepared to not meet up with someone who wants something different to you.”
In today’s post-Truvada era, for many queer men sex comes with a burning question: “To bb or not to bb?”. Okay, it may not be quite as Shakespearean, but it is surely one of profound consequences. We’re the first population of adults in which HIV rates are falling, and now that the crippling fear of the AIDS epidemic is finally subsiding, many of us have responded by relaxing about condom use.
The reasons for this are of course PrEP and U=U. But, despite those two being unprecedented medical victories, in many conversations on the subject just a mention of HIV transmission being impossible through condomless sex and it’s never too long before the celebration is cut short by the all-too familiar “you should still always wear a condom”. A well-intentioned collection of words which – despite its simplicity – has proven notoriously difficult to connect with. Its moralistic subtext leaving many feeling unheard, increasingly exasperated, and even bullied.
I’m a sex-worker. Although I use condoms in almost 100% of my work, in private the ratio is a lot closer to 0 than 100. You might think the earth-shattering HIV diagnosis I received in 2013 would change that, or that having to be treated for various STIs over the years would ‘straighten’ me up. But you would be wrong. It’s certainly taken me on a turbulent journey, but if there is anything it didn’t teach me, it’s to like condoms.
Why? Why can’t I just take on board a piece of advice so many seem to trust and avidly give out, and just wrap it every time I have sex? “Mental inhibitor”, “physical barrier”, “sensation thief” “AIDS reminder” and “boner killer” are only a few common reasons. When you reduce sex to risk – which is certainly a common trend – they’re all likely to be dismissed without a second thought.
So, instead of justifying condomless sex, I’m going to take you on a little journey where – STI by STI – I’ll examine what happens when you do always wear a condom.
HIV (Human Immunodeficiency Virus)
Let’s start with HIV and, for this part, pretend I’m HIV negative. I’m going for a hookup. Hot vibe. Clothes off. Dicks hard. Condom on. Wooh!
In this scenario, I’m very safe. HIV is almost never transmitted orally, and – for anal sex – condoms are an amazing 85% effective. This used to make them indispensable to me but that was before medicine provided us with PrEP – the blue pill that keeps the virus away – which is 99% effective. That was also before U=U – or Undetectable equals Untransmittable – which means you can’t get HIV from an HIV+U person, even if you don’t use a condom. This has been an approved medical fact for a few years now.
Hepatitis A, B & C
Moving on to hepatitis. Again, hookup, hard-on, condom, bang.
Am I safe from Hep A, B and C? While condoms reduce the risk of contracting any of them, their protection is only high for Hep B, since it’s mostly spread through blood and sexual contact.
Hep A and Hep C are mainly transmitted in two different ways. To get Hep A you need to ingest poo molecules, which may sound improbable but it’s easily done through rimming or any other way your mouth comes into contact with someone’s ass – even by proxy such as fingering, unwashed hands, or ass-to-mouth.
Hep C transmission happens mainly through injecting drugs, and rarely through sex.
This means condoms have questionable application when it comes to Hep A and Hep C.
However, for Hep A and Hep B there’s a vaccine which is a lot more reliable than any condom.
Although there is no known vaccine for Hep C, there is actually a cure. Plus, many people clear the infection without medication.
Herpes (Human Simplex Virus)
Next up: herpes – the star of countless slut-shaming punchlines, and my personal favourite.
For this part let’s imagine I’m 19 years old and don’t have much sex, never out of a relationship. As agreed, I always wrap it up. In fact, I’ve never not used a condom in my life, even with boyfriends.
Now, what if I told you that I already have herpes? Hold up! WTF? How is that even possible, if I’ve always used a condom?
It’s because herpes spreads through skin contact, which renders condoms useless in protecting you against it. But don’t feel bad for me. Although herpes is incurable and may be painful during break-outs, it isn’t actually dangerous and for most people the breakouts are rare.
Most sexually active adults contract HSV-1 (cold sore) or HSV-2 (genital herpes), but because routine sexual health screenings don’t include a herpes test, many people just never find out. Why waste time and resources on something that’s inevitable, negligible and likely to cause unnecessary distress?
You may be thinking – “okay, but cold sores and genital herpes are surely not the same” – and you would be right. Strictly speaking, they’re just cousins. But there’s a twist. Most of the herpes appearing in genital areas (let’s call it #SlutHerpes) is the cold sore virus transferred from non-genital areas. You can get this during sex, but you can also contract it from, say, your mum kissing you on the cheek when you’re a kid or even her giving birth to you (we shall call this #MumHerpes).
What does this mean? It means the only real difference between a cold sore and genital herpes is the stigma. It means, either of the two strains can end up on your genitals and you wouldn’t be able to tell them apart. It means that many of us get herpes long before we become sexually active. And it means that almost all of us have (and have spread) herpes, even without showing any symptoms.
Isn’t it crazy that decades spent harbouring the belief only certain types of people get STIs have all been leading to the realisation that every nasty herpes joke anyone has ever made, they made about their own flesh-and-blood mama. And brother. And wife. And child. Best friend. Favourite teacher. Local priest. The Pope. Quite probably, even the Queen. How LOL is that?
HPV (Human Papilloma Virus)
Moving on to HPV (the wart virus). Transmission wise, pretty much the same story – I’m likely to catch it even if I use a condom. However, unlike herpes, HPV is not something to take lightly – it can cause cancer. The great news is that although condoms are ineffective here, an HPV vaccine does exist.
Chlamydia, Gonorrhoea & Syphilis
And what’s the score for the bacterial infections, like chlamydia, gonorrhoea and syphilis? Well, condoms are very good at preventing anal transmission – particularly when you’re the one getting fucked (bottoming does increase the risk).
But, to avoid bacterial STIs altogether, you’d have to forget about sucking, rimming, heavy petting, and even kissing – unless you use protection for all those at all times – since they can all result in transmission. Some recent studies even show kissing is the number one cause of oral gonorrhoea and chlamydia.
Controversial, huh? And yet it could very well be true. It really looks like, whatever you do, you may not be able to avoid a bacterial infection after all. The good news here, however, is that all three of these are easily treatable, and don’t cause complications – as long as they’re detected early.
The conclusion on condoms
So, in addition to their use being impractical and unsustainable, condoms actually seem inferior to most other prevention tools, and the risk reduction they offer is limited enough for you to contract many STIs regardless of whether you use one or not.
I realise that, to some, this conclusion may appear unthinkable and unwelcome, while to others it will be a long awaited relief.
But I’ve not gone to all this effort just to secure my right to bareback. I don’t need approval or permission to do that. I also didn’t write this to put happy condom users off condoms. After all, it’s a personal decision.
What I want to do is to invite you to engage your capable mind in some critical thinking around sex and sexual well-being, and to start asking questions.
For example, what is it exactly – because it’s neither science nor common sense – that allows condoms to occupy such an honourable position in our minds, culture, and sexual well-being promotion, while other more effective tools like PrEP are not being distributed widely?
Are condoms really just good self-care or are they being employed for other reasons? An easy substitute for education? A fix for the guilt and shame surrounding sex for pleasure. A ‘cure’ for anal?
Consequently, ask yourself why so many of us continue to disengage from this trend. Are we all just irresponsible troublemakers? Or are we, perhaps, just building immunity to the fear the narrative of sexual safety has been saturated with?
Throughout history, our sex, our love and indeed our entire queer being, has been systematically misinterpreted, shamed, invalidated, legislated, and criminalised. To add insult to injury, we then got the blame for one of the biggest plagues this world has ever seen – the original name for AIDS was GRID, or Gay Related Immune Deficiency. It wasn’t until it was observed in heterosexual people that the epidemic was finally acknowledged. How do we recover from such desecration of our identity when we continue to be misinterpreted, violated and, all too often, reduced to little more than risk?
That said, though we may be disproportionately affected by this phenomenon, it isn’t just our community to whom sex-negative social attitudes are doing a huge disservice. Shaming, even in the most indirect of forms, does nothing but enable oppression and create barriers to our wellbeing – including sexual wellbeing – regardless of sexual identity. It affects all of us.
I don’t know about you, but I sure think it’s about time we set a new standard for this conversation. I genuinely believe that if anyone wishes to discuss something as personal and delicate as our sexual behaviours – especially if they intend to hand out unsolicited advice on how we ought to govern our bodies and interactions – they should be expected to enter the conversation with nothing short of pioneering insight, and a level of sensitivity and respect our entirely natural, incredibly complex, and fucking beautiful sex deserves.
Why do we never see condoms in gay porn?
We recently conducted a survey about porn. That’s the kind of work we do – we’re tackling the big issues, asking the hard questions. People need to know.
For the porn survey, we asked our readers a lot of personal questions. It was a survey, not a scientific study, but it did give us lots of interesting insights and things to think about and explore.
One of the key themes that seemed to emerge from the men that we spoke with, was some differing points of view regarding the use of condoms in gay porn.
Pretty much all of the porn that we see now doesn’t involve condoms, and some porn deliberately celebrates that – using the terms ‘bareback’ or ‘raw’ to promote that they are condom-free. Our survey indicated that a lot of guys want that, they don’t want to see condoms in porn, and that good porn is bareback porn. However there was a definite percentage of our respondents who felt that not using condoms in porn was irresponsible, that it sent ‘harmful’ messages about safer sex, and undermined health campaigns about condoms preventing the transmission of HIV and other STIs.
We caught up with health specialist Matthew Hodson of NAM Aidsmap to try and understand what our survey results might be telling us about gay men and condoms.
Why do you think condoms are such a big deal when it comes to porn?
Porn is fantasy sex. It’s not surprising that many people don’t want to grapple with the realities of sexual health in their fantasies.
Fairly early on in the HIV epidemic, most of the porn industry adopted condoms as standard, not least to protect the actors. Often the condom use was not commented upon, with the condoms magically appearing mid-scene. Some of the major porn producers reissued old movies as ‘pre-condom classics’ to meet the demand for condomless movies.
Increasing access to porn online changed viewing habits and helped pave the way for a massive rise in the consumption of bareback porn. Some of the new titles not only portrayed condomless sex, but actively celebrated the potential for transmission, selling the fantasy of ‘breeding’ and ‘seeding’ – often irrespective of the actual HIV status of the performers.
It’s impossible to say with certainty what the relationship between bareback porn and rising rates of bareback sex was exactly. Gay men certainly didn’t need bareback porn to inform them of the possibility of bareback sex. but we know that a lot of gay men felt that watching porn influenced their own sexual behaviour, including the sexual risks that they were taking.
With HIV medication making guys with HIV undetectable, and the availability and effectiveness of PrEP, are condoms now superfluous for gay men?
The idea that safer sex begins and ends with using condoms is out of date. Someone who is HIV-positive and undetectable on treatment doesn’t pose any transmission risk to sexual partners. PrEP, when used correctly, is almost 100 percent effective, and certainly offers greater protection against HIV than condom use alone.
Condoms still play a role in safer-sex. Condoms also prevent the transmission of other STIs, and for some men they’re preferable to the prospect of taking drugs to prevent acquiring HIV.
Are some gay men not hearing the information that’s currently available regarding PrEP and Undetectable=Untransmittable?
It can be difficult for some gay men – particularly those who lost friends and lovers during the worst days of the epidemic – to accept that the safer sex message has evolved. PrEP, when taken as prescribed, is almost 100 percent effective. There are no recorded cases of someone with an undetectable viral load passing the virus on sexually. Both offer greater protection against HIV acquisition than condoms do.
Before effective treatment came along, when we had lost thousands of lives to AIDS, I’m sure the idea of a pill that could prevent infection would have been hailed as little short of a miraculous gift. Now, with a greatly reduced death toll, just such a treatment has been tested and found to be effective. PrEP should be embraced and celebrated.
Different safer sex strategies will suit different people. The important thing is that individuals are supported to adopt a strategy that they can keep to and that will be effective for them.
Is it accurate to suggest that some gay men are struggling with moral judgements regarding sex and condom use?
For many gay and bisexual men, condom use has become intertwined with morality and notions of being a good gay man. That notion has caused harm. Telling someone that they’re wrong or disordered because they prefer to have sex without condoms, only serves to alienate them from sexual health messaging.
Condoms are good for gay and bi men because they prevent transmission of infections – but that doesn’t make condom use morally superior to other methods of preventing HIV acquisition.
What role does porn play in conveying sexual health messages to gay men?
Some performers have actively used the platform that porn has given them to promote sexual health. Jason Domino has made promotion of PrEP central to his work, and also has been helping to share the message that people who are undetectable on HIV treatment can’t pass the virus on to sexual partners. Kayden Gray is very open about living with HIV, and has also spoken out about sexual exploitation, chemsex, and issues relating to consent.
Our survey indicates that gay men are watching a lot of porn. Is porn a good way for younger gay guys to learn about sex?
There are a number of ways that you can argue that porn can give people a distorted image of what sex is like. Not least among porn’s problems – as a guide to sex for the inexperienced – is the high level of racial stereotyping or the virtual exclusion of some ethnic groups from porn, the additional pressure it puts on people to conform to particular body-types, the expectation that all men have large cocks which can be easily accommodated, or the commonplace absence of any discussion about HIV status or sexual safety.
But it would be naive to think that it’s porn’s role to educate. The ease of accessing porn makes it all the more vital that LGBTQ-inclusive sex and relationships education is taught in schools, to counter some of the myths and misinformation that porn fantasy might support.
If you were talking to a young gay guy about sex, how would you explain how to try and protect yourself against STIs?
Even though biomedical HIV prevention methods – such as PrEP – don’t stop STIs, that doesn’t mean that their use is going to increase STIs. People who get their PrEP use monitored will also get regular STI screens. In one major London clinic, they’ve seen a 24 percent decline in cases of gonorrhoea among their PrEP users because more gay men are getting screened regularly. Plus, if they’re found to have the infection, they get treated and cured before they pass it on.
Getting people into clinics is vital. It’s easy to have infectious gonorrhoea, particularly in the throat or arse, without any symptoms.
You can be vaccinated against HPV, Hepatitis A, and Hepatitis B. You can reduce your risk of acquiring STIs by using condoms, by avoiding penetrative sex, or by having fewer partners.
If you’re sexually active, you should get a full sexual health screen at least once a year, more often if you have had several sexual partners. The more regularly people are screened for STIs, the earlier that they’re diagnosed and cured, and the less opportunity there is for them to pass on the infection.