"PrEP whore" and "condom spitfire"?
Gay sex and protection strategies
Over the course of their lives, gay men have to repeatedly negotiate which protection strategy they choose for sex. This often leads to conflicts, says our author. He works as a sex educator and runs sex education events in which he talks to gay men about their feelings regarding various prevention measures.
The sexologist Volkmar Sigusch put forward a bold thesis in the 1980s when he wrote an essay on the social situation of male homosexuals:
"That many homosexuals know how to mobilise and consume more pleasure in an hour than many heterosexuals in the course of a year, that they experience things that exceed the imaginative activity of normal people, that they not only somehow outshine the others quantitatively, but are much more imaginative and capable of adjustment - one could already know this for a while." (Sigusch 1984, p. 112)
Of course, his thesis is not unfounded, as he refers to the empirical results of US sex research and sexual medicine at the time. In addition, and this is the decisive factor, he consistently reflects on the situation of homosexual men in social terms and asks himself what tensions their sexuality is charged with. According to Volkmar Sigusch, homosexuality retains a subversive and utopian content precisely because for gay men it goes hand in hand with being brutally marginalised from "normality", but also with being comparatively outside the normative impositions. This enables some gay men to free themselves from the illusions of bourgeois society, and "that makes them freer and unhappier, if that is what it means." (ibid., p. 110).
Many of them also lead a double life: Particularly compliant and decent in their working lives in a generally bad situation, they would still receive a personal pleasure bonus. Of course, these considerations cannot be applied to the present day, 36 years later, or only in part. Rather, heterosexuals and homosexuals have adapted more and more to each other, have become mutually homosexualised and heterosexualised to a certain extent. Today, it would perhaps be rather bold to claim that social integration goes hand in hand with desexualisation.
However, there is a development that began at the latest at the time of publication of the aforementioned essay and is still relevant to the sexuality of all people today, and in particular to the sexuality of gay men: the AIDS and HIV complex. This continues to allow gay men to experience things that go beyond the imagination of normal people. According to sexologist Martin Dannecker, the sexuality of gay men is subject to a law of fear under the dictates of AIDS. The dictates of AIDS exacerbate fundamental fears and feelings of guilt towards sexuality and at the same time allow them to emerge in a new and transformed form. In practice, gay men changed their sexual behaviour quickly, consistently and efficiently in the face of the emergence of the disease, which was very often fatal at the time. Although they found themselves "forced to restrict their sexuality" (Dannecker 2019, p. 59), the vast majority of them followed the new "safer sex" rules with astonishing diligence and thus contributed to successful HIV prevention.
Since then, however, the sexuality of gay men has been continuously accompanied, if not partly burdened and dominated, by this very HIV prevention and its demands, because the tragedy of gay sexuality has since then sometimes been its persistent connection with HIV and the prevention of its spread. It therefore seems obvious to me to relate the ingenuity, attitude and imaginative activity - as well as the double life mentioned above - of gay men today to how they deal with HIV and their relationship to sexuality.
The fact that the sexual practices and ideas of gay men continue to revolve around HIV is illustrated by the multitude of strategies for preventing infection or transmission of the virus or for reducing risk. Because the list of strategies is long and if you relate it to the sexual behaviour of gay men and the ideas that people have about the sexuality of gay men, you come across two of their outrageous and "risky" cores: anal intercourse and promiscuity. Those who talk about HIV and gay men are possibly not only referring to the risk of transmitting the virus, but are also, consciously or unconsciously, addressing the scandal that (some) gay men afford themselves: they fuck themselves in the arse and have sex with (many) changing partners.
HIV and the possibility of infecting yourself or others can now be dealt with in very different ways: Condom use, PEP, PrEP and protection through therapy are probably the most common. Serosorting, seroguessing, therapy sorting and negotiated safety make the decision for or against safer sex dependent on the suspected or known serostatus of the sexual partner. Barebacking refers to the decision not to use condoms for various reasons; strategic positioning strategically chooses the active or passive role during sex in order to reduce the probability of infection; withdrawal refers to the decision not to ejaculate during sex; bugchasing and pozzing describe the deliberate infection (or playing with the possibility of infection) with HIV; finally, there is (partial or complete) abstinence, i.e. abstaining from sex, certain practices or direct sexual encounters.[1] Last but not least, a further, often unnamed strategy for dealing with HIV is not to choose protection, i.e. not to make any changes or adjustments to one's behaviour to protect against a possible infection, either situationally, in phases or in the long term.
Since the turn of the millennium at the latest, which of the strategies is used and chosen has been negotiated under the heading of "individual risk management", which places informed decisions and risk assessment by the individual at the centre of prevention approaches.[2] In this context, Deutsche Aidshilfe is now known to represent the so-called Safer Sex 3.0. standpoint, which advocates the equivalence of the protection strategies condom, PrEP and protection through therapy. Ironically speaking, Safer Sex 3.0. thus represents a kind of new "holy trinity" of gay prevention work. While this position advocated by Deutsche Aidshilfe, when applied correctly, emphasises the equal value and equal rights of three protection strategies - which is medically proven and correct - the users each have their own relationship to the available protection strategies.
For individual gay men, condoms, PrEP and protection through therapy are at best equal and equivalent in terms of attitude or in the expression of their values and norms, but in many cases they naturally have clear preferences, decisive opinions and ideas about effectiveness and practicability and, in particular, very specific fantasies about the different protection strategies. The latter fantasies do not only relate to the technical dimension of protection strategies. However, prevention work - and this is due to its logic - ultimately focuses on precisely this technical dimension. Prevention is about feasibility, it addresses rational individuals who are capable of adapting their behaviour, it always refers to risks and their avoidance and prevention, it is therefore always incomplete, it dramatises (also in order to legitimise and maintain itself), it offsets costs and benefits against each other, its consequences are normalisation, individualisation, totalisation and (attempts to) tame a bad thing that lies in the future (cf. Bröckling 2008).
However, things are very different in the individual's psychological household. Here, fantasies, ideas and feelings are of central importance, which relate to protection strategies, their users and, above all, the effects on sex life. Whether these fantasies and ideas correspond to reality or represent a wish is of secondary importance. They manifest and mobilise the sexual biography, sexual education paradigms and sexual morals of the individual men as well as their sexual desires and their ideas of and about sexuality. In a certain situation and with certain sexual partners, one decides in favour of or against a certain strategy - not only due to the mere function of protection, but rather also due to the (desired) experience of sexuality and intimacy, due to sexual needs or due to certain (fusion or demarcation) desires.
In a total of around a dozen sexual education workshops with gay and bisexual men, I have pursued the goal of calling up and reflecting on precisely these references to protective strategies against HIV. This also seems sensible because the "biomedicalisation of the AIDS dispositive" (Langer 2008, p. 239) has multiplied the protective strategies against HIV. In the past, the rule was: put a condom on when fucking and get out before giving a blowjob. That no longer applies today. As a result, habits and identifications with protection strategies are irritated, the negotiation of possible protective measures during sex takes a different course, is communicated more in direct sexual encounters or remains invisible and no longer requires direct exchange. Last but not least, current developments are unsettling for quite a few gay men, and the (in and of themselves welcome) biomedical advances in HIV treatment and prevention are also accompanied by (biographically based) offences for some. Sometimes you have to say goodbye to the good old condom or put up with the fact that others (want to) do the same.
Sceptical voices about the medicalised HIV prevention that PrEP represents are in danger of being drowned out by the enthusiasm of PrEP activists. In any case, various discourses play a role in the debate surrounding PrEP: both an optimistic liberation discourse, which sees PrEP as an opportunity for democratic biopolitics and the liberation of gay sexuality from stigmatisation (Schubert 2020), and a sceptical medicalisation discourse, which also points to the risk of the development of resistance to active substances and raises medical ethical concerns (Bochow 2019). Outside of the specialist debates, highly unobjective and highly emotional contributions are also repeatedly part of the debate about the pros and cons of PrEP. PrEP users are then criticised or insulted ("PrEP whores") as irresponsible "virus spreaders" and egoists who are "only" concerned with their own sexual pleasure. In contrast, condom users are sometimes accused of being old-fashioned and conservative ("condom bourgeois").
These disputes can have concrete consequences: Many an initially tense sex date comes to an abrupt end because completely different ideas about how to deal with HIV clash. The condom as the reason for a wordless end to a sexual encounter; PrEP as a reason to confront the other person with assumptions or accusations about their lifestyle and state of health; protection through therapy as a panic-inducing AIDS and death trigger. In these dynamics, one's own attitude towards sexuality and its possible consequences is also called into question. All of this is illustrated by the sometimes highly emotionalised and dramatic discussions within the gay scene about the respective protection strategies[3].
In the workshops mentioned above, participants wrote down or told their fantasies and associations about four strategies for protecting themselves against HIV and four ways of dealing with HIV. In all sexual education events, the gay and bisexual participants were asked to give free rein to their thoughts and - far from social desirability, meaningfulness or beliefs considered politically correct - to collect their own impulses and images regarding condoms, PrEP, protection through therapy and no protection and to make them visible (anonymously if necessary) on pinboards. The feedback was to relate to the strategy itself, its users and the effects on their sex lives. The participants then discussed and reflected on the results together. All of the following quotes, supplemented by individual sentence elements, are taken verbatim from the collections from the workshops and summarised as examples.
The condom - "good, well-behaved, safe"?
The condom is tried and tested, familiar, classic, it's like a kind of home, tactile to boot, it makes me feel safe, it protects me from the other person (and their dirt), it's so beautifully functional, it's everything and I've only had one thing in life, no experiments, in short: pleasure and freedom through security and control! The condom is compulsive, cumbersome, unstable, it tears, it pinches, it squeezes, it stinks, it disgusts me, it punishes me, condoms? Ask my cock!, old-fashioned, a half-measure, a pleasure killer. Anyone who uses condoms is well-educated, sensible, responsible, but inhibited, a goddamn bourgeois, the normal case, the good guy, alien to the scene, type: stamp collector, an occasional fucker, a control freak, they are: threatened with extinction. Sex life is well-behaved, normal, clean, unspontaneous, regulated, annoying, restricted, it's agonisingly safe, my head fucks me, technical and distanced.
PrEP - "poison sling with hammer sex"?
PrEP is scary because it's invisible, it's magic, I can't believe it, devil's stuff, it divides us, what have I got in me?, it's chemistry, darkroom and somehow modern. PrEP is the realm of freedom, taking matters into your own hands, it's innovative, uncomplicated, it reminds me of THAT every day, it's the sexual revolution! PrEP means change, trust, flexibility! Its users? Those eternal preachers, the young, wild guy, the scene goer, the city dweller, the horny slut, dirty whore, so experienced, so open-minded and enlightened, privileged. The PrEP user is reliable, responsible, he's so brave, modern and self-reliant, up to his neck in STIs. PrEP is a good deed. Pioneers of gay sexuality, but: selfish and self-centred. Their sex life is bombastic, it's spontaneous, free, relaxed, informal, flexible, flexible and flexible again, wild, wildest, wildest, debauched, varied, safer, pleasurable, here they just fuck around, at orgies, and by the way, finally in ecstasy, somehow uncomfortable, because it puts pressure on me, it doesn't make me more beautiful, nobody loves me anyway, then comes the addiction?, aimlessly.
Protection through therapy (TasP) - "proud, horny victims?"
With protection through therapy, there is finally peace, having arrived in a safe harbour, it is practical and reliable, it is invisible and scary, with TasP comes the stigma, it is the unknown world of positives, it belongs to me, it makes me so vulnerable, TasP is elaborate, impressive and EXTREMELY safe. There is no alternative, because: It has to be! Its users are infected, and healthy, they are poor, left to their own devices, they take responsibility, they once made a serious mistake, they are a role model for us all, but sleeping with them? informed, honest, you feel safe here, can you trust them? The sex is liberated, authentic, challenging, trusting, these are the really horny pigs, somewhere between tension and relaxation, wild and safe, concealed and hidden.
No protection - "hated, condemned, idolised"?
No protection is ineffective, ignorant, uninformed, lacking front and back, nothing understood, completely extreme, worrying, irresponsible and thoughtless, that should be PUNISHED! And yet it is courageous, but also desperate, completely crazy and simply human, it can go well! Anyone who doesn't protect themselves is pretty stupid, actually fearful, repressive, has lots of problems and pretends to be tough. We can't recognise who it is! Find the host! They are disgusting, broken and also mysterious. But: they are so brave, they do what we would all like to do, they are dreamers, they live in the here and now, they are totally enviable, daredevils, naive and happy, they jeopardise our community, crisis! Their sex is spontaneous, carefree, dangerous but maximally pleasurable, irresponsible and PURE freedom!
In conclusion, it is hardly surprising that the fantasies about the four protection strategies mentioned and the ways of dealing with HIV are contradictory. Promises and wishes are attached to them and transferred, norms are negotiated and exorcised, admiration and contempt prevail. The condom is associated with conservatism, sexual wasteland, familiarity, nostalgia and security. PrEP is primarily associated with innovation, revolutionary and pioneering spirit. The emphasis on sexual freedom and the assumption that users will enrich themselves sexually and have lots of sex is remarkable. At the same time, there is also concern about the consequences of a lack of sexual freedom and medicalisation. TasP is generally associated above all with a sense of responsibility, information, control and an increase in life satisfaction. At the same time, pity, discomfort, guilt and envy are expressed. Very clear and strong images emerge in relation to the renunciation of protective measures. The presumed escalation of desire is sharply condemned, admired, pathologised and envied. This is hardly surprising, given that the renunciation of protective measures (seemingly) leads to an almost impossible state: getting rid of the demands, impositions and burdens of prevention, i.e. sexuality without the influence of HIV and AIDS.
All protective measures and ways of dealing with HIV ultimately remind us that this carefree sexuality does not exist. At the same time, the feelings and fantasies mobilised in the face of protection strategies have much less to do with HIV and AIDS than one might think. Rather, they are also an expression of the ongoing double life of gay men: they struggle to maintain a decent health balance while still hoping for their pleasure bonus. If they were less identified with protective strategies and had to discipline themselves and others less, the pleasure premium could possibly be very different[1].
Literature
Bochow, M. (2019): From safer sex to pre-exposure prophylaxis (PrEP). In: Henze, P.; Preis, V.; Lahl, A.: Psychoanalysis and male homosexuality. Contributions to a sexual policy debate. Gießen: Psychosozial-Verlag, pp. 259-278.
Dannecker, M. (2019): Sexuality and AIDS. In: hes, Continuing interventions. Hamburg: Männerschwarm Verlag, pp. 52-64.
Langer, P.C. (2009): Damaged identity. Dynamics of sexual risk behaviour in gay and bisexual men. Wiesbaden: Verlag für Sozialwissenschaften.
Schaffar, W. (2020): Solidarity Biopolitics: Condoms, Masks and Parallels between the HIV and Corona Pandemic. Available online at: https://www.zeitschrift-luxemburg.de/solidarische-biopolitik-kondome-masken-und-die-parallelen-zwischen-hiv-und-corona-pandemie/ (Last checked: 24/06/2020).
Schubert, Karsten (2020): Controversy over HIV-PrEP: Stigma, homophobia and the liberation of gay sexuality. Available online at: https://magazin.hiv/2020/01/24/hiv-prep-als-demokratische-biopolitik/?fbclid=IwAR0-84yLPxQPIwYQ_B-tZJX1Uh-zCz0oqNt78wcSPtvhiAzQzFzD9e4WrQ0, last checked on 14/02/2020.
Sigusch, V. (1984): Persecuted, conformist, subversive. On the social situation of homosexuals. In: Vom Trieb und von der Liebe. 2nd revised edition. Frankfurt/Main: Campus, pp. 104-115.
zaunfink (2018): From sodomites to PrEP sluts: Trails of sexophobia. Available online at: https://derzaunfink.wordpress.com/2018/05/18/vom-sodomiten-zur-prep-schlampe/ (Last checked: 24/06/2020).
[1] Embedded in a qualitative study, the various strategies can be traced in Langer (2009).
[2] Schaffar (2020) is critical of this.
[3] An examination of sexual hostility within these discussions can be found on zaunfink's blog (zaunfink 2018).
