Condoms Are Not Enough

Earlier this week Simon Copland launched a salvo at anyone that dares to engage in risk-taking sexual activities. While the underlying message of safer sex is necessary after the sharp rise of HIV transmissions this year, particularly in the 20s demographic, the overly simplistic message is not going to address the underlying problems. Nic Holas later published a counterpunch in response, which he outlines such an approach is stigmatising. I take the issue further, and it is something I have commented on before.

Condom use is still the best means of preventing the transmission of most sexually transmissible diseases, to the point that most of the sexual health sector would encourage its use even amongst long-term committed relationships. What Copland’s message does not do is engage with the broad number of psychological and social issues that inflame people’s desires around risk-taking behaviour. It is not like condom use is not a message that isn’t already out there.

Even though condom use plays an important role in safer sex, an over-reliance on it shifts the issue away from the issues of desire and aversion, and does nothing to speak to the underlying causes of risk-taking sex. The implicit message is one that equates risk-taking sex and aversion to condom use to stupidity, rather than trying to grapple with the harder question of why people pursue it even with the knowledge that there are potential dangers.

There are multiple studies that have sought to find out the answer to this question. Some of the best scholars on this subject include Michael Shernoff (author of the book Without Condoms) as well as other authors like David Moskowitz and Michael Roloff. What this research shows, among other thing, is that desire is a powerful drive that isn’t incredibly rational, and that this is why simplistic messages of condom use doesn’t enter people’s thinking when influenced by incredible sexual appetites; especially when that is compounded by drug or alcohol use.

There are a great number of underlying motivations that complicate people’s thinking, some of those include a sense of distance from the impact of HIV, a sense of invincibility in youth, a desire to embrace a sexually liberated lifestyle, or even a sense of stifling dread that they will eventually contract HIV and thus leading them to giving up on trying. While none of these should be seen as justifications, they do speak to the fact that human sexual psychology is incredibly complex, and therefore no single one-stop solution will work completely.

So any approach that fails to grapple with these complex issues relegates the legitimacy of those desires into the taboo. When something becomes taboo it becomes shameful and stigmatised. More, the denial of these desires creates a sense of forbidden fruit, and that tends to excite and inflame those desires. When taboo behaviours have no opportunity to discuss those desires publicly without shame, those discussions go underground.  It is little wonder that MSM who are hungry for this type of risk taking behaviour are finding ways to meet in a discreet manner outside of the gaze of a disapproving public.

By making it harder for people to speak candidly about their experiences, their acts, and their risks, it actively discourages people to approach and access public health services when they do. It means that people who don’t normally partake in risky sex acts, or perhaps indulge in one after normal judgment is impaired by alcohol have a huge disincentive for approaching sexual clinics for services like PEP, or even PrEP.

So what is the solution? There is no single solution, but to start it’s best to think in terms of safer sex, (rather than safe sex). No sex is completely safe, and so any approach to condom use must be accompanied by a humanisation of desire and transmission. STIs are fundamentally a human problem, and if we only approach it with only a clinical solution we begin to dehumanise the people involved.

Silence leads to erasure, victim-blaming, and a breakdown of community.

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Queer Technologies and Reproductive Rights

The issue of Zoe’s Law (2) remains unresolved. Three sessions of parliament have passed where the issue has been debated. I was a member of the audience in that parliament for the last two, along with a large contingent of protesters against the motion.

One of the issues that has come up around my participation was why I felt this issue was a queer issue. I thought I would take the time to explain myself on that. While I think that these matters are primarily an issue for women, they are part of a broader narrative of queer resistance against the medicalisation of bodies and bodily autonomy. For a really good contemporaneous example of this conflict, I would refer you to the opposition against medical intervention of intersex children – it is a similar refrain that homosexuals fought to have their sexuality declassified from being a mental illness 30 years ago.

Women should hopefully find allies on this issue within the queer movements, and I encourage women to embrace this issue as an intersectional one, to oppose the medicalisation of sexual bodies.

Queer Technologies

So much of the history of the queer movement has been around challenging medicalised notions of sex, sexuality, and gender, and shifting them more towards a framework that is about actualisation. By this, I mean that these struggle seek to make the experience of personality superior to the experience of embodiment, and using a variety of technologies to help change, control, and remodel our physically lived experiences to suit the designs of our personality. While the most obvious example of this relates to the use of hormones and surgery to assign and reassign sex, issues that relate to the regulation and control of reproductivity are also part of that broad spectrum.

In many ways, this struggle is directed towards the way we understand the practice of medicine, and various technologies within its purview. It seeks to move medical practice away from normalising bodies towards a position of liberating those bodies instead. That is, so much of queer resistance is against a medicalisation of sex, sexuality, and gender. It is against the co-option of medicine and science to construct our bodies in a manner that is useful only to patriarchy and heteronormative ideas.

[Queer Resistance] seeks to move medical practice away from normalising bodies towards a position of liberating those bodies instead.

Reproductive technologies are a subset of what I consider queer technologies because of the way they remove the constraints of biological determinism. They challenge traditional notions of sex, gender, and sexuality. They reconfigure them from serving reproduction, to serving a broader range of agendas, including identity, pleasure, and power.

For women, intersex people, and trans people (amongst others), queer technologies are granting autonomy over our bodies, that they might be shaped in a way that conforms with their desired experience of that body. Thus, I consider the pill as one of the world’s first queer technologies, because it helped precipitate the sexual revolution by granting women control over their reproduction.

The Medicalisation of Bodies

Medicalisation is a process that uses medical expertise and knowledge to render phenomena of living down to its basic biology and physiology.

Medicalisation is a process that uses medical expertise and knowledge to render phenomena of living down to its basic biology and physiology. Our distinctiveness is described less in the context of social characteristics, and more in terms of anatomical and biological ideas. In doing so, medicalisation tends to view difference and variation in a very pathological manner, because definitions of ‘health’ refer frequently back to standard and normal models. Consequently, medicalisation is actually counterposed with legal notions of personhood, because it actively seeks to move away from social predicates of being towards medical ones.

That is, the law is itself a social construction. It is limited by an issues called the fact-value distinction, which means that any issue before the law must distinguish between empirically observed matters (facts) and what those facts mean for society (values). Because it is almost impossible to determine what we ought to do based on what has been observed, the law must refer to social values to give those facts meaning. Thus the law is a fabric of social values, which gives meaning, agency, and power to a variety of things and interactions that happen around us.

More importantly, the law must reduce complex ideas down into simpler ones. The law is inherently reductive because it struggles to cope with ambiguities. Not only can thousands of dollars depends on an interpretation, but judges are required to return a definitive interpretation. Leaving room for ambiguity only serves to undermine a piece of legislation. Check out my Beyond Binaries policy brief for how many of these issues play out, even under a legal framework that seek to be actively inclusive.

The Carriage of Personhood

In the instance of foetal personhood, the above-mentioned issues are doubly troublesome. On one hand it personifies a foetus, and on the other hand it medicalises a mother. That is, it gives a foetus the status of a personality, and it reduces a mother to her caricature as a uterus. She is no longer a mother, but a carriage for another person.

The problem here is that this law is conflating personification with the ascription of personhood. Personification is understandable, because mothers and parents are neurologically wired to bond with their children, and humanity has historically inscribed human characteristics onto all manner of things. Even babies are capable of recognising faces, revealing that it is something of an innate skill.

However, the reason that personification must be distinguished from personhood is because one has significant social consequence. Personhood imputes agency through entitling an entity with a suite of legal rights. Agency is a crucial component of the law, because it relates to actions and agendas, not merely philosophies. To grant personhood is to grant agency to an entity. It means that that entity has the capacity to impact upon and interact with the law.

Children are given increasing amounts of agency as they mature, until they are recognised by law as being responsible for their own choices. This is another reason why it is important to allow personhood to be dependent on birth, not merely the appearance of humanity. Children may be dependent on their parents socially speaking, but a foetus is dependent for its very existence on its mother. A society can remove an infant from the custody of its mother if it deems it to be in the best interests of that child. However, the law only permits medical intervention to remove a foetus from a mother in situations that are medically justified.

Bodily Autonomy

This brings us back to my original position. These shifts Zoe’s Law (2) proposes would carry the unintended consequences of medicalising mothers and personifying foetuses. Moreover, granting personhood to a feotus grants them agency that would contrast that of the mother’s.

This is incredibly insidious, by medicalising the mother and personifying the foetus it increases the ambit around what justifies medical intervention. We have already seen one instance where a mother’s was entirely reduced to her capacity as a uterus, completely disregarding her status as a person. Moreover, external forces had to act as proxies for the feotus in order to act in this way. For these reasons, and for all the reasons I previously articulated, no law should recognise the personhood of a feotus.

Women should hopefully find allies on this issue within the queer movements, and I encourage women to embrace this issue as an intersectional one, to oppose the medicalisation of sexual bodies.

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Cutting the Umbilical Cord Between Church and State

AngelusProtesr

This Thursday, I will be participating in a protest before the NSW State Parliament, where a bill is being proposed that would make amendments to the Crimes Act, called the Crimes Amendment (Zoe’s Law) Bill 2013 (No. 2). It is euphemistically called Zoe’s Law (2) because it refers to the tragedy of the posthumously named Zoe, and is the second time a variant of this bill has been introduced to NSW Parliament. The substantive feature of this law would be the recognition of legal personhood of a foetus. This shift in legal definitions has a number of effects, which would significantly impact women’s rights, particularly around issues of child-birthing and bodily autonomy.

Although this is an issue I am profoundly passionate about, I had until now refrained from commenting. Partly because I do not identify as a woman, but also because far better women commentators were already weighing in on the issue and I feel I have an obligation to hear their view points before I formulate/refine my own.

However, the protest is drawing nigh and I was roused to significant anger this morning when it seemed that NSW Parliament were going to debate the bill today (until it wasn’t). To that end, I wanted to comment on the matter, not from viewpoint of being a feminist (even though I count myself as one), but as a legal scholar. I therefore seek to address the fundamental question at the heart of this challenge, which depends on the point at which the law recognises a subject as a legal person.

Ultimately, my objections refer back to the significance of legal personhood, and the immense problems that arise in extending that status onto any entity that does not have a separate existence from its mother. While it is incredibly understandable that a mother would want to have some manner of public recognition for being deprived of a child, doing so through a criminal process is one with far too many social consequences.

Outline of Zoe’s Law (2)

To outline exactly what the law would do, I refer to statements made in the Bill’s first reading, as introduced by Mr Chris Spence MP, as well as a statement provided by the mother of the eponymous Zoe.

The object of the bill is to amend the Crimes Act 1900 to recognise the existence of the foetus of a pregnant woman that is of at least 20 weeks gestation so that proceedings for certain offences relating to grievous bodily harm may be brought against an offender who causes the unlawful destruction of or harm to any such foetus as proceedings for grievous bodily harm to the foetus rather than proceedings for grievous bodily harm to the pregnant woman.

The above is the opening paragraph of Mr Spence’s first reading of the bill. He goes on to note that the bill as introduced is a refinement of the original bill submitted by Fred Nile, in that it would exempt any offences that would occur in the “course of a medical procedure, including medical treatment or anything done by or with the consent of the pregnant woman that causes harm to or the destruction of a foetus” and does not intend to impact upon a woman’s right to choose.

However, the very specific aspect of the amendment is schedule 1 [2] of the bill, which states:

For the purposes of the proposed section, an unborn child that is taken to be a living person for the purposes of applicable offences, is defined as a foetus of at least 20 weeks gestation or, if that cannot be reliably established, a foetus that weighs at least 400 grams (proposed section 8A (1) and (2)).

It specifically states that the intention of the amendment is to enable the law to recognise an unborn child as a living person, for the purpose of a range of applicable offences. Mr Spence claims that it would not create new categories of crime, but rather focus on the crimes of grievous bodily harm that are currently relevant to injury toward a foetus.

There have been some preliminary responses from a variety of legal experts who have expressed concern and dissent to these intentions of the bill. Roughly speaking, a variety of legal organisations and experts (except for lawyers known for being anti-abortion) have been consulted and come to an opinion that it is something of a Trojan horse for women’s choices. There is a legal conceit in Zoe’s Law (2), in that while it allows for exemptions from medical procedures that women choose to undergo (such as the termination of a foetus), the passing of this bill would nonetheless establish the legal category of “foetal personhood”. It would instate that foetus with a series of protected rights that would potentially come up by virtue of the fact that this foetus is now viewed as a separate legal entity.

One of the comments regarding this conceit is that because this entity would not technically have a category until the passing of the bill, it has not been included in any of the pre-bill analysis of the bill’s proponents. It is this exact same pattern that equivalent bills in the USA used to be passed as legislation. It is why such bills are being advocated for by anti-choice veterans like Fred Nile and current Attorney-General and former ‘Right To Life’ president Greg Smith. Among those, I would direct you to the responses written up in this article by Jabour in the Guardian.

For a good grounding in the background of the current legislative provisions as they apply around the legal recognition of the personhood of children being born, and how they intersect with crimes like manslaughter, I refer you to the review by the Judicial Commission of New South Wales.

Donegan’s Appeal and Legal Reasoning

One of the things that is seen as particularly compelling in this case is the public appeal by Brodie Donegan, which is regarded as convincing because Donegan is a self-professed pro-choice mother. In her view (and as articulated in the amendment), the provisions of the amendment would still protect women’s choices.

Rather than refer to specific passages of Donegan’s appeal, I will simply outline that it describes the way that Donegan experienced a highly traumatic event, and that Donegan ‘s experience of the still birth was one akin to having lost a fully realised child. A lot of her language speaks to visceral memories that are undoubtedly painful and extremely difficult to reconcile. That this loss has taken place in the context of an accident would likely exacerbate those memories and experiences. To these I can only sympathise with, even while I have no significant frame of reference to empathise with.

However, as a legal scholar, I am required to step back from these subjective experiences and ask whether these experiences should formulate a dimension of criminality. The important question being asked is not whether there is validity to Donegan’s claim or experiences, but whether these experiences speak to a significant truth or aspect of our society as a generalisation. While this bill would not directly seek to create new crimes, per se, it does expand the way existing criminal legislation interacts with unborn children.

The reason I treat this issue with some measure of skepticism is because to consider an issue before law it is necessary to identify what the relevant questions of fact are, as well as those questions of law. In the account detailed above by Donegan we see references being made to the fact these events occurred on Christmas Day, the interactions between the unborn child and he potential sister. All of these are appeals to emotion, designed to qualify the experience beyond a tragic accident where an unborn child was stillborn. If they are relevant facts, than any law that is made in response to them would need to include ‘happening on Christmas Day’ or ‘the unborn child had siblings’ as conditional aspects before the law became relevant. They are understandably personally relevant to the family in question, but legal reasoning must remain agnostic to them.

My argument against this amendment does not depend on this fact, because it would be disingenuous to do so. Clearly the arguments for this bill do not entirely turn on these issues, but they add an undercurrent personalisation that I think only serve to muddy the discussion. These are incredibly significant issues and cannot be resolved through emotional appeals.

The Autonomy of Being

The substantive basis for these types of claims, and in fact the point to which Donegan points to as the point at which this law should kick into effect, relates to the fact that currently levels of medical technologies can enable a foetus at 23 weeks to become a viable baby outside the womb. Proponents of the law will point to the status of a foetus at 20+ weeks, to indicate that they should be reasonably recognised as a separate body (see this video as an example).

In a first glance, it might make common sense to regard these entities as living persons. They share all of the apparent characteristics of babies, and can be made as a viable separate entity. It is around this particular test that the idea of the ‘born alive rule’ emerges, which is the legal test applied to births to determine whether the birth should be recognised as having personhood. It currently holds that a birthed human being becomes a legal person when they are able to breath independently from the mother, even if that breathing is machine assisted.

It is to this idea that the challenge of Zoe’s Law is levelled, reasoning that since technology can enable a foetus to survive at increasingly earlier stages, we should recognise earlier stages as being potentially viable. This is a false equivocation, because the born alive rule is a test applied after birth, irrespective of the period of gestation. Its premise is to identify viability after the fact, not seek to pre-empty viability in potential. For an extremely excellent academic response to this kind of challenge, I would refer you to Kristen Savell’s article in the Sydney Law Review.

She concludes that:

“the law should resist pressures to enlarge its understanding of personhood on the basis of some straightforward analogy between late-term foetuses and newborn infants. The comparable intrinsic properties of late-foetuses and newborns is not alone sufficient to warrant the ascription of legal personhood to foetuses. The conditions that make late-term foetuses resemble persons certainly include intrinsic properties but, until the foetus achieves separation, they also include the investments and attachments of the mother. Foetuses cannot become actively embedded in a social matrix and, to the extent that the foetus becomes situated in a web of relationships, this is only achieved through its mother. However, after birth the baby can become actively embedded in a social matrix irrespective of its mother. It is in this sense that the experience of individuated embodiment has substantive significance.”

What this means, and what I wholeheartedly agree with is the rebuttal that just because a foetus has the outward appearance of a natal child does not mean it should be entitled with the full suite of human rights. What I find inherently troubling by this particular line of reasoning is that it attributes personhood towards a body, but this says nothing about the really thorny question of whether that foetus has consciousness, or bears many other signifiers of socialisation that are also intrinsic qualities of being human. To ascribe those social qualities onto a foetus before it has become actualised as an independent person is premature (please excuse the pun, but I cannot find a better synonym).

Legal Construction of Personhood

From a much more broader theoretical perspective, I am deeply troubled by some of the implications of recognising personhood for any foetus that has not yet achieved independent existence from its mother. This is largely due to the way that the legal system interacts with medical bodies of knowledge, particularly around matters that have criminality attached, but are often insulated from sociological considerations, which specifically investigate questions of identity and personhood in terms of its meaning to society.

The very notion of legal personhood is a rather difficult one, because the legal system has taken what we consider to be rather essential elements of being and framed them into highly discreet categories. The problem is that our lived experiences and the realities of being a full actualised human are not able to be reduced so easily. Personhood is actually a complex of various socio-legal boundaries, each of which circumscribes a certain kind of social space with legal provisions. Each boundary represents some ideal of personhood or individuality, which is then framed as some kind of real thing. While I describe four spheres of personhood in this model, I will mention only the inner-most two as I consider they are the ones truly relevant when discussing this matter.

The innermost sphere describes those qualities of personhood we might regard as the ego, and here the Anglo-American tradition of law protects our rights to hold beliefs and ideas, and otherwise protect against psychological injury. The second boundary is effectively equated our body, and while the body encompasses the ego, the laws relevant to this boundary protect individuals against unlawful medical intervention, battery, and other violations of our bodily autonomy. There are other dimensions beyond this, which relate to matters like privacy, property, and other areas of our civil and legal personhood, but since most of those are not relevant for this discussion I won’t detail them. Suffice it to say, the notion of personhood is already mutable, and recognising the existence of a legal person that still exists within and is dependent upon another person for their existence causes a direct conflict of rights that is incredibly difficult to reconsile.

Ultimately, my objections refer back to the significance of legal personhood, and the immense problems that arise in extending that status onto any entity that does not have a separate existence from its mother. While it is incredibly understandable that a mother would want to have some manner of public recognition for being deprived of a child, doing so through a criminal process is one with far too many social consequences.

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The Lover that Dare Not Sheath His Mien

This article is a polemic. It speaks about unprotected sex practices relevant to the gay community and for men-who-have-sex-with-men (MSM). The point of this article is not to serve as an apologetic, nor to serve as a health warning, but to unpack the motivations that shape people’s sexual behavior. This article does not advocate for unsafe sex practices, but rather to address the silence on on a highly taboo subject. The longer this conversation remains unspoken, the greater the numbers who take uninformed risks.

What is being discussed here refers not just to individuals who occasionally conduct unsafe sex, but also individuals that live it as part of their lifestyle (even integrating it into their identity), whether they are HIV+ or not, and even people who actively seek HIV infection (bug-chasing). It’s a complicated subject, and the only way to speak to it is to consider the convergence of cultural, sexual, medical, and even historical influences, rather than the individuals themselves.

… there is a limited ability for the criminal system to offset risky sexual behaviours. A stronger and more effective approach would be to address the matter principally as a public health issue and one probably best supported by community development.

The Criminalisation of HIV Transmission: Global Comparisons

Across the world, there are a range of laws relevant to the transmission of HIV, which all turn around the ability to provide informed consent. For the purposes of this article, I am going to limit the exploration of this issue to Anglo-American contexts as it makes for an easier point of comparison. Generally speaking though, most jurisdictions regard an act that either deliberately or recklessly transmits HIV, and so the issue hinged on whether an individual knowingly (whether intentionally or not) contributed to transmission. There are three main contexts that I would like to compare to give a sense around how we ascribe criminality to these matters: Australia, Canada, and the UK. I choose these three nations as a comparison, because they all share a very similar judicial systems, but also because they have inherited the British colonial legacy.

Australia generally regards HIV transmission under both criminal law and public health law, but specifically in New South Wales, the intentional transmission of HIV a criminal act considered grievous bodily harm (GBH), and there are additional requirements to disclose HIV status to potential sex partners.

Canada has some similarities, though lacking any specific HIV statues. However, there are several cases that have set precedents for how these issues are ascribed. R. v. Mabior, (2012) SCC 47 attributes criminal liability to individuals for failing to disclose their serostatus, and despite being subject to significant antiretroviral therapy and despite intermittent condom use, had not transmitted HIV in that period. The ruling found that these actions constituted sexual assault, due to the lack of informed consent on the part of his partners. This, combined with earlier rulings, has established a precedent that means a combination of failing to disclose serostatus and failing to use safer sex measures constitute a sufficiently fraudulent act to vitiate the consent given, transforming the act into sexual assault.

In similar vein, the UK has seven convictions on record for HIV transmission, which pertain to the reckless infliction of grievous bodily harm. What is interesting in the UK situation is that the numerous cases provide a series of comparisons, making determinations around different thresholds of consent. The UK courts have variously found defendants guilty for reckless behaviour in situations where they knowingly were diagnoses as being HIV+ but failed to inform or take protective measures (much like in Canada and Austalia). In one of the two cases where the issue went to appeal, the judgement opined that there may be different standards of consent for those within a committed relationship, compared to those engaging in casual sex. In the other case, there was a specific distinction made between assuming some general risk with casual unprotected sex, and the informed risk relevant to the disclosure of HIV-status.

The Culpability of Desire

Since the birth of clinical medicine, medical thought has sought to produce a philosophy of the human subject and how one should live, but this internal humanism mutates through the new medical technology. This medicalisation was a rendering of natural phenomena into a medical and authoritative framework. It increases the scope of human phenomena encompassed by medicine through a paradigm of disease and treatment. Thus, medicine is discursive and empowers medical professionals as authorities and patients as dependants with little valued medical input. The consequence being the ontology of the human became increasingly produced through medical imperatives. This discourse turns upon a dichotomy of rendering issues into being either normal or pathological, which subsequently frames the issue of public health as risk management, using statistical analyses of probabilities to construct a notion of morality and health. This framework consequently is co-opted by legal thinking, which merely reinforces the issue of legal personhood as being an embodied phenomenon, which simply embeds legal responsibility onto bodily acts.

What we can see on the comparison of these issues is the significance of informed consent to risk, however the tendency to categorise the act as GBH means that consent may not qualify as a sufficient defense, even informed consent. The comparison can be made to R v Brown (Anthony), where consensual sadomasochism resulting in significant injury still constituted a criminal act that was not vitiated by the consent of the participants, nor the lack of complaints filed by the same.

Considering these are criminal matters, particularly considering that in some instances the State intervenes directly with the private conduct between individuals, it is making a determination around the management of HIV transmission as having a public interest.

What we see here is an attempt by three comparative legal systems in relation to determining culpability, or legal responsibility. On these matters, Kane Race seeks to frame how and why these judiciaries and legislatures apportion responsibility for HIV transmission. In particular he notes that despite advances in biomedical research on HIV transmission, there is an increasing tendency for these bodies to confer culpability on discrete individuals, often signified through bodily acts. Specifically, the more the virus becomes framed in the context of medical research, the more that such bodies attribute responsibility to bodies (and thus the person embodied within). That there is insufficient distinction in these matters between the legal person and the body they inhabit is a direct result of the medicalisation of this matter, and one that erodes the complex socio-cultural impetus underlying seual relations, as the primary vector for transmission.

Considering these are criminal matters, particularly considering that in some instances the State intervenes directly with the private conduct between individuals, it is making a determination around the management of HIV transmission as having a public interest. This is where it gets really complicated, because while it is easy to conceive of HIV as a public health concern, it is so intertwined with the individuals who are HIV+ and their sexual practices that the socio-cultural dimension cannot be set aside.

Of interest, Buris points to this, stating that the experience of being HIV+ is viscerally experienced, and that the criminalisation and stigmatisation of HIV are so closely aligned. Not only can being HIV+ dislocate people from their existing social networks, but that the criminalising of HIV transmission creates a strong disincentives to neither test nor disclose. In his work, he show how HIV exposure is not deterred by criminalisation: one third of high-risk sexual subjects never test, preferring not to know their status and thereby making them feel absolved of social and legal responsibilities. Many HIV+ persons fail to disclose their status to primary partners, with only one-half disclosing to casual partners.

Subcultures of Risk and Dissent

Shernoff once wrote a seminal text on the subject called Without Condoms, and in it he explored the psychology surrounding this issue. As a sexual behaviour, barebacking is contextual, to the point that it mostly describes a specific experience of unprotected sex. It is heavily taboo and mostly refers to male-to-male sex that is casual and/or anonymous.

He noted that the emergence of barebacking emerged out of a tension between gay civil rights movements embracing sexual hedonism as statement of sexual liberation, and a slow and resentful reaction to accept the reality of the health risk epidemic created by HIV. Specifically, he highlighted a number of factors that inform the desires and choices regarding barebacking. These can include aversions to condom use or other safe sex, the ‘sanctity’ of a committed relationship, alienation from mainstream gay identities that produce a desire for deviant experiences, internalised homophobia, fatalism of eventual infection, and substance use.

In building on this another scholar named Joffe, in her work ‘Intimacy and Love in Late Modern Conditions: Implications for Unsafe Sex Practices‘, identified a strong correlation between unprotected sex practices within the formulation of committed relationships between same-sex male partners. Primarily, this signified the emotional ties experienced in this transition: she cited studies that suggested that condom use signified a given act of sex act as public and impersonal, while the lack of condom use construed the act as personal and intimate. In this way, she argued that the condom has come to signify a barrier against intimacy.

Specifically, she stated that these interconnections do not describe an aversion to condom use because of a sense of boundedness or limitation, but rather a desire for the emotional tie viscerally experienced in seminal transmission, which heralds the achievement of emotional intimacy.

Specifically, she stated that these interconnections do not describe an aversion to condom use because of a sense of boundedness or limitation, but rather a desire for the emotional tie viscerally experienced in seminal transmission, which heralds the achievement of emotional intimacy. That this experience can be so highly desired, is one of the factors Joffe attributes to overriding our instinctive drive for the preservation of our own health. Moreover, she notes that attitudes towards sex inform condom use overall. Where sex signifies an expression of love and intimacy, than the discontinuing condom use signifies the establishment of trust, which transforms the relationship from the casual to the stable, while continued use undermines the sense of exclusivity and commitment.

Joffe attempts to place this issue in the context of modern society, where there are increasing levels of anonymity and environmental variations: the continuous flux of stimuli intensifies emotional states, which subsequently sanctifies our private and intimate spaces. That is, the private arena becomes authentic, and the public arena creates alienation, meaning that the establishment of authentic relationships through intimate bonds becomes a means for us of establishing mental and emotional integrity in the face of this onslaught.

The Stigmata of Faceless Men

Drawing from both Shernoff and Joffe, and moving beyond the context of relationship building, there is still a large arena where risk-taking occurs, and while some of these practices are attempts to confer intimacy on anonymous encounters, there is a much more complicated range of motivations at play. Effectively, we are talking about a large range of social and personal issues that feed into sexual appetites, which consequently over-ride preservation instincts. Some are inherently self-destructive and nihilistic, while others merely result in self-harm. Ironically, one of the greatest social pressures that intersect with these issues is the stigmatisation barebacking because of its direct association to HIV transmission.

A positive HIV status symbolical carries a loss of sexual liberty, and HIV+ people have frequently reported experiences of becoming dislocated from the mainstream community groups, and thereby find support and solidarity in other similarly stigmatised people. Consequently, this act of separation merely helps to reinforce risk-taking sexual behaviours into a sense of identity because it becomes the means of participation in groups that do accept them. However, group participation doesn’t account for individuals who have casual attitudes towards barebacking. As Shernoff notes, they include a various range of issues, including ambivalence towards the health implications, and fatalism experienced regarding STI infection.

Shernoff conducted a study of those who engaged in barebacking behaviours, and saw that even though a fairly large number of the men sampled were willing to risk infection, the actual number of those who intentionally sought to transmit the virus was infinitesimally small. Of those who deliberately sought to become positive their motivations were a complex tangle of conscious and unconscious motivations. In some circumstances, the anxiety experienced over infection was so intense as to be debilitating. To then proactively control the situation in which they become positive and to finally have concrete knowledge of their status gave them a sense of empowerment they lacked from the state of limbo created by uncertainty of status.

Of Biopolitics and Laws

A lot of ground has been covered in this article, ranging from the legal reasoning behind criminalisation of acts relating to HIV transmission. However, the legislation of a criminal act is a very binary one, either something is criminal or it is not. If the matter is unclear, the court system is required to produce a finding one way or the other and cannot leave the matter ambiguous. However, it does show that there are some complex social phenomena and interactions that the law has difficulty accommodating these nuances and thus defers to the reductive medical models. This means that currently, the law is framing the matter almost purely in terms of its interactions with bodies, rather than with people; while there is some tendency to recognise the agency available to people in their sex acts, it still frames the criminality of the act through the way it is embodied.

However, it is clear when the sociological and psychological dimensions are taken into account, that there exists a much broader ambit of motivations and interactions that are affecting the diversity of choices and encounters around sexual behaviour. More, that there is a limited ability for the criminal system to offset risky sexual behaviours. A stronger and more effective approach would be to address the matter principally as a public health issue and one probably best supported by community development.