Sex without Condoms

Gay culture moves fast. So it wouldn’t be a big surprise if the 2006 published book by Michael Shernoff Without Condoms – unprotected sex, gay men & barebacking felt a little dated. Or it might simply be the perspective of a gay man who came of age just before the AIDS crisis and who’s personal life was forever shaped by it. But the material is as relevant as it has ever been.

Michael Shernoff is a Manhattan psychotherapist who has written extensively about mental health issues of gay men and HIV/AIDS. The topic is personal to him, as he is himself a gay man and HIV positive. At times his barely suppressed anger and frustration seep through his narratives and cases studies. Why do men knowingly put themselves and their partners at risk for a still deadly disease? Much of the advice the author gives to the professional therapist in these pages reads like a reminder to himself and in the last chapter Michael refreshingly admits to his own struggle for neutrality.

The book starts out with a brief definition of terms and then goes into an overview of the reasons why gay men have sex without condoms. The first part also recaps the changing attitude of therapists towards gay men and stresses the importance of gay affirmative therapy. The second part explores in detail how male couples view condom use in relationships. Should the condoms come off? When and under what circumstances? The third and last part of the book talks about the role of the professional therapist and the community. It shows that even the most personal acts performed behind closed doors are indeed political.

The uneven voice of the book at times gets in the way of the material. The style changes from scholarly article directed at fellow therapists to personal narrative and then surprises the reader with easy to read practical advice. Still, the book presents a tremendously useful collection of material and presents a very nuanced view. The author opens himself up to the un-resolvable ambiguities of the subject while laying out the full spectrum of answers. He lets us witness his own struggle for neutrality when confronted with the idea of a healthy gay man actively seeking to become HIV positive. He leaves the reader with no doubt that he rejects the notion that all unprotected sex is as an expression of low self-esteem or self-destructive behavior.

For my own work as an HIV testing counselor, I found a very readable introduction to the concept of risk reduction in HIV prevention and the “Stages of Change” model. He further describes in detail the wide range of ways gay couples do or do not deal with the issue. He gives a step-by-step introduction to “negotiated safety” for male couples and tackles the connection between drug use and unprotected sex.

One area where the book does create the impression of being dated, is Michael’s description of venturing into the online world of gay sex. He describes it with the clinical detachment of an outsider who is privately wondering what ever happened to gay bars and old-fashioned cruising in parks and along the waterfront. Though I don’t think you have to be older to wish for a time of more personal interaction, stronger community and less separation in the digital age. Whether this is a wish for a better future or a yearning for days gone by depends on the optimism of the reader.

The book closes with a chapter on sexual freedom and sexual responsibility. Freed from the need to provide accurate information, the author finally finds his most authentic voice. He asks some hard questions that force the reader to move from the personal to the political: “Why should gay men matter to each other? How do we extend consideration and concern to other men with whom we have sex?” Michael finally reminds us that freedom is rarely a clear-cut path, but often leads into areas of complexity and moral ambiguity. Negotiating sexual desire, love and deadly disease often requires a guide with an open heart, patience and compassion for the fellow traveler. Michael Shernoff has shown with his book that, even in the face of his own imperfections or maybe because of them, he has all three in abundance. Thanks Michael for putting so much of your time and love into the project and for sharing it with all of us.