Project Name: Frontiers in Prevention (FIP)


Funding Source and Project Period: NIMH R01 MH069333, 07/18/03 – 06/30/06


Key Personnel:
Principal Investigator: Alex Carballo-Diéguez, PhD.
Co-Investigators: Robert H. Remien, Ph.D.; Michele Shedlin, Ph.D.; Ivan Balan, Ph.D.; Curtis Dolezal, Ph.D.; Gary Dowsett, Ph.D.; Ana Ventuneac, Ph.D.

Project Overview:


During the last decade, Internet use has become increasingly popular, with technological advances making access to information easier and faster. Men who have sex with men (MSM) are avid users of the Internet for dating and sexual purposes. Mainstream Internet providers feature user-created chat rooms where MSM can easily find each. There are also sex-specific sites that unabashedly cater to the sexual interests of their users. This proliferation of Web sites for MSM and the efficiency with which they can be used appears to be having an impact on the sexual behavior of MSM.


This three-year exploratory study focused on MSM who meet sexual partners through the Internet to intentionally engage in condomless anal intercourse in situations in which there is risk of HIV transmission. This sexual practice is frequently referred to as “bareback” sex. The goal was to understand individual and contextual factors underlying unprotected anal sex, specifically among MSM of color and those in cultural niches that may favor risky sex.


The study was conducted in two phases. Phase 1 involved identification of  the most popular sites used by MSM residing in the New York metropolitan area to connect with other MSM with the intention of engaging in condomless sex. Then, an exploration was undertaken of how six of the most popular sites are organized, how they can be accessed, what communication tools and advice concerning communication they offer, what type of marketing occurs within them, and what language and images are used. In Phase 2, in-depth interviews were conducted of key informants (e.g., webmasters of local Internet sex sites, on-line discussion moderators, and leaders identified by regular users of Internet sex sites), and face-to-face interviews of regular users of those sites. A total of 127 individuals were interviewed (4 key informants and 123 regular users). Key informants completed an in-depth interview, either by phone, over the Internet via a chat session, or face-to-face. Regular users completed an in-depth, face-to-face interview conducted by one of three Clinical Psychologists on our staff and a structured assessment using the Computer Assisted Self-Interview (CASI) that covered issues on sexual practices in the previous two months, HIV-testing practices, and substance use, among others.

Publications (as of 4/20/10):

Balán, I., Carballo-Diéguez, A., Ventuneac, A., and Remien, R.H. (2009). Intentional condomless anal intercourse among Latino MSM who meet sexual partners on the Internet. AIDS Education and Prevention, 21(1), 14-24.

Bauermeister, J.A., Carballo-Diéguez, A., Ventuneac, A., and Dolezal, C. (2009). Assessing motivations to engage in intentional condomless anal intercourse in HIV-risk contexts (“Bareback Sex”) among men who have sex with men. AIDS Education and Prevention, 21(2), 156-168.

Carballo-Diéguez, A. and Bauermeister, J. (2004). “Barebacking”: Intentional condomless anal sex in HIV-risk contexts. Reasons for and against it. Journal of Homosexuality, 47(1), 1-16.

Carballo-Diéguez, A., Dolezal, C., Ventuneac, A., Bauermeister, J.A., Balan, I., and Remien, R.H. (2008). The use of rectal douches among HIV-uninfected and infected men who have unprotected receptive anal intercourse: Implications for rectal microbicides. AIDS and Behavior, 12(6), 860-866.

Carballo-Diéguez, A., Dowsett, G.W., Ventuneac, A., Remien, R.H., Balan, I., Dolezal, C., Luciano, O., and Lin, P. (2006). Cybercartography of popular Internet sites used by New York City MSM interested in bareback sex. AIDS Education and Prevention, 18(6), 475-489.

Carballo-Diéguez, A., Ventuneac, A., Bauermeister, J., Dowsett, G.W., Dolezal, C., Remien, R.H., Balan, I., and Rowe, M.S. (2009). Is ‘bareback’ a useful construct from a primary HIV-prevention perspective? Definitions, identity, and research. Culture, Health, and Sexuality, 11(1), 51-65.

Dowsett, G.W., Williams, H., Ventuneac, A., and Carballo-Diéguez, A. (2008). ‘Taking it Like a Man’: Masculinity and barebacking online. Sexualities, 11(1), 137-157.

Nodin, N., Carballo-Diéguez, A., Ventuneac, A., Balán, I., and Remien, R.H. (2008). Knowledge and acceptability of alternative HIV prevention bio-medical products among MSM who bareback. AIDS Care, 20(1), 106-115.

Wilson, P.A., Valera, P., Ventuneac, A., Balan, I., Rowe, M., and Carballo-Diéguez, A. (2009). Race-based sexual steretypes and sexual partnering behaviors of men who use the Internet to engage in bareback sex. Journal of Sex Research, 48, 1-15.

Bauermeister, J.A., Giguere, R., Carballo-Diéguez, A., and Ventuneac, A. (in press). Perceived strategies employed by young men who have sex with men when seeking online partners. Journal of Health Communication