An exploratory study of barebacking, club drug use, and meanings of sex in black and latino gay and bisexual men in the age of AIDS

Current epidemiological trends demonstrate that Black and Latino men-who-have-sex-with-men (MSM) have increasingly disproportionate rates of HIV. The emergence of barebacking (intentional unprotected anal intercourse) and club drug use (cocaine, methamphetamine, GHB, ecstasy, ketamine) have posed a significant public health threat for MSM. This formative, behavioral multi-method investigation aims to examine barebacking, club drug use, and meanings of sex in Black and Latino gay and bisexual (BLGB) men. The data were drawn from the baseline assessment of a larger-scale longitudinal investigation (N = 450) of club drug use in gay and bisexual men from the New York Metropolitan area recruited from mainstream gay venues, AIDS service organizations, and public/commercial sex environments. Findings demonstrated that Black and Latino men were more likely to report an HIV-positive serostatus and identify as bisexual. Significant racial/ethnic differences were demonstrated in the use of club drugs. HIV-positive men reported significantly more frequent barebacking with HIV-positive partners. Latino men of HIV unknown status perceived greater benefits of barebacking. The qualitative data suggested specific cultural and phenomenological meanings ascribed to the act of bareback sex, club drug use, and the intersection of these behaviors.