I have a question about the risks a top takes when fucking bareback. Assume that the cock is clean and free of abrasions or scratchs or anything like and assume that the bottom isn't bleeding or anything obvious like that and that he is pretty well cleaned out down there. Also assume fairly normal fucking: lots of lube, going slow, nice and easy pace, then some speed as things get hot, but no jack hammering or forcing in of the dick. Two questions:

(1) What are the things that a top can catch in that instance and how likely are they? HIV? Gonerrea? Syphilis? Hep c? Other nasties?

(2) Is there anything that a top can do afterwards to reduce any of these risks, like immediately washing off the dick with antibacterial soap or taking a piss right away?

And, yes, I know safer sex is better and that the big risks in BB are to the bottom. I've topped a few times BB, but am usually pretty nervous and (because the bottom doesn't want me to) I haven't actually cum inside someone's hole; I always pull out for that. But I am curious: what are the risks to an otherwise healthy top in fucking a clean looking, but unknown, butt?

Thanks for any insight.

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There is only one scientific study that actually calculated the odds of getting HIV while topping. There have been occasional men who insist that they got HIV from topping only, however, this seems to be rare. In very rough numbers, you are about ten times less likely to get HIV from topping than from bottoming.

In my experience, the most common problems are the standard STI's including minor infections. The chances of catching something in a bathhouse are probably 100 times greater than from fuck buddies. Washing and pissing afterward is a good idea even if there isn't any scientific proof that this helps.

The scientific studies have not been able to calculate exact odds because they have been unable to get a large enough number of men (due to budget reasons). When President Bush took office in 2000, his administration virtually cut off all of the funds for HIV studies on gay men and so there has been very little new since this article was published: (The full article is only available for a fee or from a medical library. The following abstract is free.)

= = = = FROM COPYRIGHT FREE U.S. Government Source = = =

American Journal of Epidemiology - Volume 150 Number 3 - August 1, 1999

"Per-Contact Risk of Human Immunodeficiency Virus Transmission between Male Sexual Partners." Eric Vittinghoff, John Douglas, Frank Judson, David McKirnan, Kate MacQueen, and Susan P. Buchbinder (Department of Epidemiology and Biostatistics, University of California San Francisco, 74 New Montgomery, Suite 600, San Francisco, CA 94105)

Am J Epidemiol 1999;150:306-11

The risk of human immunodeficiency virus (HIV) transmission from various types of homosexual contact, including oral sex, is of biologic, epidemiologic, and public health importance. The per-contact risk of acquiring HIV infection from specific acts was estimated in a prospective cohort study of 2,189 high-risk homosexual and bisexual men, conducted in San Francisco, California; Denver, Colorado; and Chicago, Illinois, in 1992--1994. During 2,633 person-years of follow-up, 60 seroconversions were observed. The estimated per-contact risk of acquiring HIV from unprotected receptive anal sex (URA) was 0.82 percent (95% confidence interval: 0.24, 2.76 percent) when the partner was known to be HIV+ and 0.27 percent (95% confidence interval: 0.06, 0.49 percent) when partners of unknown serostatus were included. There was heterogeneity in per-contact risk, with nine seroconversions occurring after only one or two episodes of URA. The per-contact risk associated with unprotected insertive anal and receptive oral sex with HIV-positive or unknown serostatus partners was 0.06 and 0.04 percent, respectively. URA accounted for only 15 percent of all reported sexual activity by seroconverters. As lower-risk practices become more common, they may play a larger role in propagating the epidemic and should also be addressed by interventions targeting high-risk homosexual and bisexual men.

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Dude, you are at risk for EVERYTHING -- and I do mean EVERYTHING.

That's the bottom line. End of story.

When you start talking about "what ifs" and "assume this" and "assume that," you are trying to justify what you know to be dangerous and improper behavior.

Furthermore, you cannot play the odds when it comes to unprotected sex. It DOES NOT matter WHAT the actual odds are, for many reasons:

Odds are based on studies, and, as Teva said, these are extremely limited and ALWAYS MUST INCLUDE a statistical portion of the calculations which relies SOLELY on the responses given by men -- these responses may or may not be true. In my book, that pretty much ruins the efficacy of ANY study.

Odds are also of ZERO CONSEQUENCE when the time comes that you find out you did NOT beat them! If, for example, we pluck some numbers out of the air and say that one in ten men will get HIV from being a bareback top and that five in ten men will get it from being a bareback bottom (I just made that up, by the way), does it matter if YOU are the ONE out of those ten? Not at all. You've just lost, big time.

Odds can provide false confidence, giving men the notion that because they are doing something that MAY BE safer than doing something else, they should feel secure about their practice. So then they go do it AGAIN. And AGAIN. And each time you do it -- you challenge the odds even more. Eventually... well... just how many times can you spin a roulette wheel and keep on winning?

Odds CANNOT EVER be determined accurately in this circumstance. Anyone who tells you otherwise is misinformed. Just take a look at your own post if you want to understand WHY this is true, OK? You ask about all these variables -- assuming the bottom is cleaned out, not bleeding, the penis skin is intact, the fucking is slow and easy, there's lots of lube, etc. We can add LOTS more variables to the equation, too. Does anyone have another STD that makes them more likely to get HIV? Do they even KNOW they have an STD? How often has each person done it raw? With how many other partners? What risks have their other partners taken? We're looking at a string of NEARLY infinite permutations of variables which utterly DESTROY any attempts at arriving at a definitive answer. If someone tells you there are ACCURATE odds posted, they are WRONG. You can easily FIND such tables of odds scattered all over the net -- and each and EVERY one of them is based on JUNK SCIENCE. Put your faith in this charts and graphs -- maybe you die. Maybe you don't. Your choice. What will it be?

Finally, consider the Second Law Of Thermodynamics. Seriously. This is a Universal Constant which holds true at all times and cannot be violated (except for the fact that these theories break down at the moment BEFORE the Big Bang, but that was a hell of a long time ago). This law states that the energy of a closed system moves from a state of lower entropy to higher entropy. This is "Murphy's Law," to put it into simpler terms: "If something CAN go wrong, it WILL go wrong." EVERYTHING in the Universe eventually will break down when subjected to linear time. This holds true at the subatomic level as well as on the galactic level and the Universal level. What this means is that while we cannot accurately predict everything that will happen in the Universe, we are damn sure that sooner or later, everything will break down. Our human bodies are included in this. Natural aging and subsequent death are a great example of this: your body ultimately breaks down -- the energy of your closed system becomes less and less ordered, until it no longer functions. Why rush that process, right?

Play the odds long enough, INCREASE the odds of no longer being able to BEAT the odds. Factor in all the variables and realize there is no such thing as a definitive answer to your question. Give yourself enough exposure to linear time, entropy increases; the system becomes weaker.

Look... you CAN most certainly "get away" with NEVER getting an STD. Maybe. But the fact is: you'd be an idiot if you keep trying. You already KNOW you are putting yourself at HIGH RISK. Just because you are at "lower" risk than the bottom guy doesn't mean you still are not engaging in a high risk sexual activity.

If the entire Universe will someday succumb to the Second Law of Thermodynamics (and already is), what makes YOU so special?

Dude, you're question is a GOOD one. There are no stupid questions except those that are never asked. I'm not trying to be hard on you for the sake of being an asshole -- I'm laying out the facts with blunt force here because you need to know the truth.

Lastly... when you bareback, you INCREASE the rate of entropy to the closed system (that is not really all that closed) of the gay community as a whole. You may have already spread SOMETHING to someone that you got from someone else and NONE of you even know it yet. Doesn't even have to be HIV -- you can have ANY other STD and not be aware right away.

Go to Walgreen's right now and buy some condoms, OK? Think of it as your own way of foiling Mr. Murphy.

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I agree somewhat with the other responses, but think Scruffy's has a bit of an alarmist factor to it. No offense dude.

My Doctor has said to me that the risks for HIV infection from topping are minimal. The thing is, if the bottom you're fucking has andSTD like Gonnorhea, the virus is plentiful at the site of infection which is the asshole and puts you more at risk of infection. Other than that, if the bottom is free of STD's, lubed, clean and you're scrape free and what not, the risk is minimal.

As far as other nasty STD's go, anything is game. You can get all the other nasty's very easily from topping bareback so choose well who you fuck raw. Although these other STD's are curable, they make for a very uncomfortable few days, visit to the Dr's office and what not. Some may say this is worth the price of a hot raw fuck, it's really you're own way of risk management that will determine what's okay for you and what's not.

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I agree with Scruffy. I also agree with the impression that he sounded a bit alarmist on the whole matter. My question to the round: when are you supposed to be an alarmist? In my books, when life is at stake. I am no friend of any drama in life, but this one richly deserves it.

Most of us here have been around the block a few times. We have cruised the bars, the baths, the parks, the gyms, etc. I daresay, few of us had any real chance to perform a quick medical check and establish the fact that the bottom dude was clean, STD-free, abrasion-free, etc. So, how do you 'carefully' choose your partner? Based upon his looks, age, attire? And those will somehow tell you about his health status? Nope, I don't think so.

Quite a few guys saw the problem in promiscuity and tried to counter it by moving within the same circle of buddies. You trusted them - they trusted you or so the story goes. In reality, all of our buddies have other buddies and other buddies have those they are not sharing with them. Which all brings us to square one.

All of us here are free men and all of us are free to fool ourselves, if this is what we choose to do. All of us apply risk management startegies to survive anyway. Yet, to select someone over someone else for the 'raw sex' really boils down to playing Russian Roulette. Fooling yourself that you know how to manage that risk remains your prerogative, but admitting to the truth that you are fooling yourself equally so, remains your moral obligation to the others and to yourself as well.

The truth is that your survival in this respect starts at the moment you stop to practice the denial of reality and admit to the fact that given circumstances require appropriate survival strategy on your part. That strategy excludes unprotected sex. Some will tell you that you have limited your freedom by embarcing this choice. Indeed, you have. Many will tell you that you have made a very wise decision. Both of those hold truth.

KD

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The San Francisco City Clinic has a great chart showing what can be transmitted to each partner during various sex acts. Here are the risks for 'Anal sex - top'

known risks: Chlamydia, Crabs/Scabies, Gonorrhea, Hepatitis B, Herpes, HIV, HPV (warts), NGU, Syphilis

unknown: Hepatitis C

Full chart at http://www.dph.sf.ca.us/sfcityclinic...s/stdchart.asp

Read After Sex Hygiene at http://www.dph.sf.ca.us/sfcityclinic/drk/faq8.asp
I agree with tevaboi- I piss & wash my dick afterward even though I don't BB.

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Kewl:

Well thought out response, but want to make sure the fooling yourself comments weren't directed towards me as I'm speaking to the topic at hand, giving my thoughts, not discussing my own personal sexual practices.

The thing is, in my opinion when it comes to any kind of self destructive behavior, risk management works far better than the alarmist strategy. You've heard this before I'm sure but just look at the "Just Say No" campaign. At least with risk management, you can work with the person and grow towards ultimate self preservation, or at least more than they started with. The all or nothing alarmist, do or die approaches just push people away and the information needed to get to them falls on deaf ears with no progress being made.

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Nope, I did not mean 'you' as in you, personally but 'you' as one, or anyone who acts in that manner.

I also agree that risk management is a better alternative than a non-productive 'Just Say No' approach. For most people 'Just Say No' really does not represent a viable alternative at all.

When it comes to unprotected sex, I do however advocate a very firm 'NO' even at the risk of sounding like an alarmist. There is absolutely nothing wrong with saying 'NO' and practically all of us do it very frequently. You have to draw the line somewhere. I clearly draw it at the point, where I know that the life of others and myself might be endangered. This is acceptable to the most. Saying 'NO' to having sex with other people is both ridiculous and unviable.

No matter what the arguments are, some people will do what their instincts tell them to do. Those of us with a strong self-preservation drive will most likely stick with their 'safe sex practice'. Those with 'a strife towards death' will play their own version of the worst Russian roulette and will possibly take the others with them on their way...

Yet, there is a significant number of people out there who are trying to make an educated decision on how to behave. I see every virtue in simply telling them where to draw their lines in a most unambigous fashion. There is a huge body of scientific evidence to support this view. Few will take the trouble to go through it and the others will simply accept the strength of arguments expressed here.

KD

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If stating the facts is "alarmist," then so be it. Give me any label you like which may make you (generic "you") feel comfortable about your own state of mind and perception of the barebacking problem within the gay community.

The way I see it, this is just MORE bullshit political correctness: "even barebackers need LOOOOVE." Fuck that shit. Barebackers are fools and they spread disease. Period.

Others can pander to the sensitivities of barebackers if they wish. I choose not to do so.

Those who are familiar with my opinion already know that I seriously disagree with this kind of liberal-love fest attitude towards the problem. If I had my way, I'd like to line up all the barebackers and parade them one by one into an AIDS ward -- let them SEE the consequences of their actions first hand. THAT would put an end to it -- FAST. Mark my words.

All this hand-holding and coddling and "gentle, crystal-blue persuasion" accomplishes NOTHING.

Keep on reinforcing the notion that topping is "safer" and therefore somehow "more acceptable." Watch HIV infection rates rise. Watch your friends suffer and die. Fun, fun, fun.

We seem to have forgotten an important point here: if just ONE of the partners refuses bareback sex, that breaks the cycle. The top is just as responsible for this as the bottom. So all of a sudden, we are giving these veiled hints based on bullshit charts and graphs to tops, letting them know that their risk is minimal, so hey, what the hell? May as WELL enjoy it and forget the rubber, right?

HOW DO YOU THINK THE BOTTOMS GET INFECTED IN THE FIRST PLACE? THEY GET INFECTED FROM INFECTED TOPS! And how did the tops get infected? Hmmm? Either from an infected bottom, from another form of sex, or from drug use, right?

Versatility -- the badge of honor in the gay community: "I do it all." Yep. And you spread disease even faster, dude. Coooool...

You know, I have to be honest here -- I'm SERIOUSLY disappointed to see ANY sort of defense of barebacking WHATSOEVER. There is NO room for tenderness here. No room for soft whispers and gentle encouragement. These stupid fucks need a kick in the ass and a punch in the nuts, that's what they need.

I used the Second Law Of Thermodynamics as an example here because it is TRUTH and it MATTERS. The Universe cannot escape the consequences of entropy -- and barebackers need to realize that they are indeed a part of the known Universe. It's not nearly as obscure as it sounds. And let me tell you something... once you have HIV, there's nothing quite like it for increasing the entropy of the closed system that is your human body. Nope. Nothing quite like it at all. It does a DAMN good job of putting an end to your own PERSONAL Universe.

If some of you desire, you can sit around a roaring campfire and sing songs with the barebackers, hold their hands and align their chakras, help them seek out their "inner white light" and get in touch with their spiritual centers. Maybe this is the best form of psychology for some of the dimmer bulbs out there.

But when you're all done with that, give me a podium, an empty lecture hall, and a movie projector. File them all inside. I'll give a talk and show a few films and maybe some slides. I'm gonna bet that after they SEE what AIDS REALLY is, when they hear the family and friends weeping at the graves of loved ones, when they see a human body stripped of all dignity and beauty, eaten away by a PREVENTABLE VIRUS -- when they SEE this and when they HEAR this -- THAT'S gonna be what they remember the longest. THAT'S gonna make them reach for that condom EVERY FUCKING TIME.

Perhaps their chakras will be nicely aligned and glowing with pretty colors, too -- and that's great. But the REALITY of AIDS will be fresh in their minds and won't be likely to ever fade away.

You know what? We don't have the fucking TIME anymore to be sweet and sensitive. In fact, we TRIED that bullshit not too long ago. HIV infection rates, after a period of steady decline, WENT BACK UP. We don't have the time to sit around and try to figure out how to be delicate about this anymore. These dumb fucks need a slap in the face -- a real wake up call.

What AMAZES me is all these folks who complain about the Bush Administration's lack of attention to the HIV epidemic -- and these are the SAME people who want to coddle and hand-hold the barebackers, leading them into some sort of New Age "EST" seminar of chanting and burning patchouli incense. The SAME people who bitch about the lack of focus on HIV in this nation are the SAME ones who want to explore the "sensitivity" of the barebackers. HUH? If the Bush Administration started putting out TV ads warning of the risks of unprotected sex, would we then complain about that as being "alarmist," too? Or is that what we want? I'm confused. Do you folks even KNOW what you want?

What steps should we take right now? What is the suggestion, then, if telling the horrifying truth is not acceptable by today's politically correct standards? Describe for me, in detail please, the process by which we should educate the barebackers. What do we do? How do we explain it to them? What is the "gentle and compassionate" way in which to drive this message home to these guys? Give me a plan of action here. I want to hear it. How do we gather them all together and teach them? What's the next move?

Utter crap. Being soft on these guys is going to result in FAR more men becoming complacent than being hard on these guys is going to drive them away.

I remember about three years ago I talked to a dude online, and mentioned this conversation here at CFS. It was the single most SHOCKING thing I've EVER heard come from the mouth of a gay man. In short, the conversation moved to the discussion of safe sex, and this man said to me, upon hearing my concerns: "I didn't know you can get AIDS from fucking."

That's right. He said it. And if ONE man said it to ME -- there are SURELY many more out there who are JUST as dumb.

Hmmm... I kind of doubt he'd respond to any sort of politically correct, liberally happy, communal GROUP HUG.

Anyway, everything I said here is TRUE:

You can play the odds, but the odds don't matter once you have LOST.

Barebacking puts you at risk for EVERY possible STD. Every one of them. No exceptions.

The cycle of HIV stops when you put on a condom.

Being at "lower" risk than your bottom partner does NOT mean you are at NO risk.

The Second Law Of Thermodynamics applies to the entire Universe, and that includes the human body.

Murphy was right.

There is NO WAY to ACCURATELY calculate EXACT odds for the transmission of HIV due to the nearly infinite combination of possible variables found in each and every sexual act. In addition, surveys based on information submitted by participants cannot be considered scientifically accurate.

These studies can give us an IDEA of risk potential, but they cannot do a damn thing to SAVE YOUR FUCKING LIFE.

Please feel free to buy me a big, red button that says "HIV ALARMIST" on it. I'll be more than happy to wear it.

And finally -- this is not a personal issue insomuch as I am "offended" if anyone disagrees with me per se. What IS offensive to me is the general notion that ANYONE in the gay community can see this deadly serious situation as something to be taken even REMOTELY lightly, defining "lightly" as being "sensitive" to barebackers (not finding HIV amusing, of course).

Free love is over, folks. These days, there is a price to pay. A HUGE price. Is it worth it to you?

What a nice message this sends to the gay youth of the world: "Barebacking is wrong, but... oh, we "understand" your desires. We are sensitive to your needs. Take a "time out" and go think about what you are doing."

Bullshit. Let's take a drive to the local AIDS ward instead. Get scared to death -- and maybe live a long time to tell others about it.

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Insulting, accusatory, defensive and long winded statements really won't do much for your campaing for safer sex. It's difficult to respond to you as you really come out swinging and well, just plain rude.

Compassion, kindess and understanding go a lot further. We're only human which makes us imprefect and some gay guys truly do struggle with negotiating safer sex. This doesn't make them idiots, dumb fucks, or whatever else you are describing them as, they're just regular guys struggling with the same issue's we all do. Just because you are kind to someone, or sensitive, doesn't mean one condones the others behavior. It's just that if we take your distancing approach, well, we won't have many guys willing to listen, or more importantly, talk about their behavior and why they do it. Information is power and you can't put the expectations out there without getting the information first as to why this problem exists. Try not to be so pathological and take a more systemic approach, you may be suprised at how your views may be the same in principal, but different in the way you want to pursue your message.

Lastly, walking gays through an AIDS ward will do nothing.
Scare tactics are very provincial and useless.

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