Barebacking, the Internet, and harm reduction: an intercept survey with gay and bisexual men in Los Angeles and New York City.

Researchers have suggested that intentional unprotected anal intercourse (UAI) among gay and bisexual men (colloquially called barebacking), is on the rise. Further, they have linked this increase in barebacking to the growth of the Internet as a medium for men to meet sex partners. Data were used from large-scale gay, lesbian, and bisexual (GLB) community events in New York and Los Angeles collected between 2003 and 2004. In total 1178 men who have sex with men (MSM) responded to questions about the use of the Internet, willingness to have unplanned UAI, intentions toward planned UAI, and "barebacker identity." Compared to nonbarebackers, barebackers spent significantly more time on the Internet looking for sex and looking for dates. Further, HIV-positive barebackers specifically spent the most time online looking for dates. Further analyses of willingness and intentions to have UAI, and the specific sexual behaviors of self-identified barebackers, found evidence of strategic positioning and serosorting, both harm reduction strategies. These data suggest both HIV-positive and HIV-negative barebackers may be engaged in efforts to reduce the risk of HIV transmission when engaged in unprotected sex.