The anatomy of a forbidden desire: men, penetration and semen exchange.

The rising popularity of unprotected anal sex (bareback sex) among men who have sex with men (MSM) is perplexing healthcare providers working in sexual health clinics. Epidemiological research on the topic overlooks several socio-cultural and psychological dimensions. Our research attempts to construct an appropriate theoretical edifice by which we can understand this sexual practice. In order to achieve this objective, a qualitative design was selected and 18 semiconductive in-depth interviews were carried out with barebackers from five European and North American cities. We then analyzed the data using two theoretical approaches that were sensitive to the issues of desire, transgression and pleasure. These theories are those of the late French psychoanalyst, Jacques Lacan, and those of poststructural thinkers, Gilles Deleuze and Felix Guattari. These theoretical frameworks helped shed light on the significance of bareback sex, and can potentially influence healthcare providers in gaining a better understanding not only of their clients, but also of their own role in the circuitry of desire at work within bareback. We found that while the exchange of semen constitutes a dangerous and irrational practice to healthcare professionals, it is nevertheless a significant variable in the sexual lives of barebackers that needs to be taken into consideration in the provision of healthcare services.