Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

XIV International AIDS Conference

Abstracts WePeE6540-WePeE6543 219

final sample, 27% identified themselves as barebackers, 57% did not, and 16%
had not heard of the term.
Results: Most barebackers (57%) indicated that they were willing to have unprotected sex with partners of any serostatus; 43% indicated limiting barebacking to
other seropositive partners. Univariate analyses revealed significant differences
between men who identified as barebackers and other MSM. Barebackers had
less negative self evaluative beliefs regarding unsafe sex (e.g., guilt/remorse after unsafe sex, M = 3.0 vs. 3.9, p < 0.001) and lower self-efficacy for condom
use during insertive anal sex (M = 3.5 vs. 4.1, p < 0.001). Barebackers were
more likely to agree that they could ascertain the serostatus of prospective sexual partners based upon a partner's willingness to engage in unsafe (M = 3.5 vs.
3.2, p < 0.001) and a partner's characteristics such as age and appearance (M
= 2.4 vs. 2.2, p < 0.001). Barebackers also had significantly more unprotected
anal insertive intercourse with HIV-seronegative or unknown status partners in
the past 3 months than other MSM in the sample (p < 0.001, M = 2.4 vs. 0.35,
respectively).
Conclusions: Barebackers represent a substantial minority of HIV-seropositive
MSM that prevention programs must try to reach. Assumptions about partners'
serostatus and condom use self-efficacy should be targeted by HIV prevention
programs for this population.
Presenting author: David Bimbi, CHEST, 250 W. 26th St., Suite 300, NYC, NY,
10001, United States, Tel.: [phone], X237, Fax: [phone], E-mail:
[email protected]
WePeE6540 A process of vulnerablelization exacerbates the
risk for HIV infection among young gay men (YGM)
A.J. Schilder, C. Buchner, M.L. Miller, S.L. Martindale, M.T. Schechter,
M.V. O'Shaughnessy, R.S. Hogg, P. Spittal. BC Centre for Excellence in
HIV/AIDS, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
Background: Few studies address the sociocultural contexts of young gay men's
(YGM) early lives that inform landscapes of vulnerability. Recent findings suggest that YGM who have experienced sexual violence are at increased risk for
substance abuse & subsequently HIV infection.
Objectives: To better understand the issue of rising HIV incidence in a prospective study of YGM, it is necessary to reveal the sociocultural dynamics of YGM's
earlier lives.
Method: Participants were recruited from the Vanguard Project. Ethnographic
data were collected through 104 in-depth interviews with 26 HIV-negative & HIV+
YGM and managed through NU*DIST software. Themes investigated include
family history, experiences with physical & sexual violence, intimate relationships
& HIV-related vulnerabilities.
Results: HIV+ YGM related that the adoption of a devalued social identity reduces social safety, social access, economic expectations & social/emotional support. Analysis suggests that a process of vulnerablelization occurs as a result of
experiences with social, sexual & physical violence; familial discord resulting in
incomplete interpersonal skills; and inevitable migration to urban gay villages.
These factors converged within liminal times of "coming out," periods marked by
predation, and nested risk often associated with seroconversion. "Coming out"
and other social transitions occurred in secret and were often unguided & uncelebrated. YGM's capacity to consider or conceptualize consent is highly overrated &
poorly defined, especially when boundaries are obliterated, undeveloped or submerged by systemic abuses & untreated trauma.
Conclusions: These qualitative results indicate for some YGM, a process of vulnerablelization occurs before they come out. HIV interventionists should be aware
of past abuse & its trauma and intervene therapeutically. Culturally safe environments are required for YGM to safely transition into adult life during the coming
out process.
Presenting author: Arn Schilder, 608 - 1081 Burrard Street, Vancouver, BC, V6Z
1Y6, Canada, Tel.: [phone], ext. 63183, Fax: [phone], E-mail: arn
@hivnet.ubc.ca
WePeE6541 Beliefs about "cum," condoms and intimacy
among young gay men (YGM) in the context of
rising HIV incidence in Vancouver
C.S. Buchner, A.J. Schilder, M.L. Miller, S.L. Martindale, M.T. Schechter,
M.V. O'Shaughnessy, R.S. Hogg, P Spittal. BC Centre for Excellence in
HIV/AIDS, 608 - 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
Background: The US CDC has expanded prevention efforts to target HIV+ individuals. In Canada, such efforts are rare. Furthermore, there has been little
research on the sexuality and sexual practices of HIV+ young gay men (YGM).
Objectives: To better understand the cultural beliefs & meanings regarding semen (known as "cum"), condom use & intimacy among HIV+ YGM. The meaning
of these concepts in the context of YGM's sexual culture and why some YGM
remain vulnerable to risks of HIV & STDs must be better understood in order to

reduce transmission.
Method: Data from 104 in-depth interviews with 26 HIV-negative & HIV+ YGM
recruited from the Vanguard Project were managed through NU*DIST software.
Themes investigated included family history, experiences with physical & sexual
violence, intimate/affective relationships & HIV-related vulnerabilities.
Results: For many YGM, cultural beliefs regarding the significance of "cum" are
related to intimacy; those who had seroconverted reported more consistently pos
itive & intimate associations with "cum" and its sexual exchange. For these men,
condoms were seen as a barrier to intimacy & "real" sex. Within consensual seroconcordant sexuality, HIV+ gay men often did not consider or conceptualize the
need for sexual protection. For these men, condoms had negative cultural connotations often experienced as barriers to the exchange of "cum," which signified
a level of desired & unexplored intimate acceptance. HIV-negative participants
more often reported distasteful or negative associations with "cum" than their
HIV+ counterparts. For HIV+ men, significant associations of "cum" with infection
seemed limited to recalling their beliefs before infection.
Conclusions: The desire for intimacy by YGM is powerful and will often challenge the rational risks associated with HIV transmission & STD infections. It is
crucial that the gay cultural significance of condoms and "cum" be understood
and addressed in any interventions.
Presenting author: Chris Buchner, 608 - 1081 Burrard Street, Vancouver, BC,
V6Z 1 Y6, Canada, Tel.: [phone], ext. 63183, Fax: [phone], E-mail:
[email protected]
WePeE6542I Looking for a tall, dark, macho man...Sexual-role
behavior variations according to partner
characteristics in Latino gay and bisexual men
A. Carballo-Dieguez', C. Dolezal', L. Nieves-Rosa2, F Diaz3, C. Decena3.
' HIV Center for Clinical and Behavioral Studies, New York State Psychiatric
Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY
10032, United States; 2University of Puerto Rico, Rio Piedras, Puerto Rico; 3HIV
Center for Clinical and Behavioral Studies, New York State Psychiatric Institute
and Columbia University New York, United States
Background: Receptive anal sex (RAS) carries higher risk of HIV transmission
for an uninfected individual than insertive anal sex (IAS). We sought to identify
what motivates either behavior in a population of gay and bisexual men (GBM)
who engage in anal sex and are inconsistent condoms users.
Methods: Our non-random sample consisted of 294 adult GBM of Latin American ancestry living in New York City, US, who had agreed to participate in an
HIV-prevention study -mean age: 32 (range 18-67), mean education: two years
of college. We asked, "If compared to you your partner is taller, when it comes to
oral sex, are you more likely to suck him or be sucked by him? And when it comes
to anal sex, are you more likely to fuck him or be fucked by him?" We asked 22
such questions grouped in 11 pairs of opposites. Results were analyzed using
McNemar tests.
Results: Respondents reported that if their partners were more macho, more aggressive, taller, darker, more handsome, older, or had a bigger penis than them,
respondents were more likely to take the RAS role. If the partner was more effeminate, less aggressive, shorter, of lighter skin color, less handsome, younger,
or had a smaller penis, respondents were more likely to adopt IAS. Identical results were obtained for oral sex. Body weight, money, independence, and national
background did not show significant differences. The proportion of individuals saying that none of the stated reasons would influence their behavior were 14% for
IAS, 27% for RAS, 17 for insertive oral, and 21 for receptive oral sex.
Conclusions: The construct of masculintiy and its attributed characteristics as
well as power issues exert an important influence on the type of sex role taken by
GBM of Latin American descent. Insertive role appears related to devaluation of
the sexual partner. Implications for HIV prevention are discussed.
Presenting author: Alex Carballo-Dieguez, 1051 Riverside Drive, Unit 15, New
York, NY 10032, United States, Tel.: [phone], Fax: [phone], E-mail:
[email protected]
I WePeE6543 HIV prevention in African American gay men:
Identifying those who are the least concerned
about HIV/AIDS
V.M. Mays1, S.D. Cochran2, C. Nellos2. 1IUniversity of California, 405 Hilgard
Avenue, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, United
States; 2UCLA Sch/ of Public Health, Los Angeles, CA, United States
Background: Incident HIV infection is greatest in the African American community, particularly among MSM's. Increasingly, HIV prevention efforts are targeted
at the African American gay male community in order to reduce risky behaviors. However, there are little data on subpopulation differences within the African
American gay male community that can help guide risk reduction efforts. In particular, we do not know who those men are that do not view HIV/AIDS as a significant concern and therefore may not attend to the prevention efforts aimed at
their behavior.
Methods: A brief questionnaire was administered in conjunction with the NGTLF
Racial Justice Initiative at nine Black Pride Festivals. The instrument asked
African American gay men (N=1,370) to indicate the three most important issues facing Black Americans in the USA. and, in a second question, facing GLBT
and queer Black Americans in the USA. Multiple issues were offered, including

HIV/AIDS.
Results: Among African American MSM respondents, approximately 52% did not
choose HIV as among the three top issues for Black Americans and 23% did not
for the LGBT/Queer Black community. These latter men were more likely to be
25-44 yrs of age, possess some college or a college degree, work in professional
or technical jobs, earn $23-40,000 a year, and were single or dating.
Conclusions: While 3/4's of the African American MSM's reached at Black gay