3.1.2 Relational Factors
Many
researchers of MSM HIV related risk behavior in the West have observed a strong
link between unsafer sexual practices and relational factors between partners such
as whether or not they are in a stable relationship (Brochow 1998, Kippax et al
1994), the degree of emotional bonding between the individuals (Schlitz 1998),
and perceptions of or presumptions about ones partner’s likely sero-status (de
Zwart et al. 1998).
Similarly,
in our study, relational factors were the most consistently reported reasons
for risk behavior in the diaries and the most highly rated in the questionnaire
survey. The relational factors rated highest in the survey were ‘having sex with
a lover’ and ‘having sex with a steady partner’. Other factors receiving
relatively high scores were ‘having a special feeling for your partner’,
‘wanting to please your partner’,
‘doing it with a younger person’ and ‘doing it with a partner whom you think
is not promiscuous’.
3.1.2a Love and Relationships
Both
the analysis of the diaries and the results of the questionnaire reveal ‘love’
to be the relational factor most strongly associated with unsafer sex. In the
context of a long-term relationship, willingness to engage in unsafer sex was
often regarded as symbol of the depth of love and commitment or a means through
which the relationship could be developed through increased ‘intimacy’. 72.9% of the questionnaire respondents rated
‘having sex with a lover’ as moderately to very highly increasing the chances
they would engage in unsafer sex. ‘In the realm of love,’ wrote one diarist
‘the worry of AIDS is put aside’ (Thomas 2, 45).
The
following excerpt shows how, in the context of a relationship, safer sex
strategies change as participants attempt to integrate them into strategies for
maintaining their relationship and increasing their degree of intimacy and
pleasure. In this example, as the relationship develops, the couple moves from
not engaging in anal sex at all, to engaging in anal sex with condoms and
lubricant, to engaging in sporadic episodes of unprotected anal intercourse,
driven by their passion and their desire to experience their sex and love as
more ‘substantial’.
OK. With my sex partner...In my first
love...I think I will use the term partner instead of "wife". In
fact, we are living harmoniously together. Regarding sex, I can harmonize with
him. Sometimes, he requests anal sex. Although, at first, I resisted as I though
that it was immoral and dirty, I finally gave in and had my first sexual
intercourse with him as he requested. In the beginning of our sexual behavior,
I felt uneasy because I worried that I might get AIDS. But later I did not
worry anymore and felt safe as we had used lubricant and condoms. .. Later, we
had more frequent sexual behavior. When we are seized with a sudden impulse to
have sex, I request him not to use condom in order to have more intimate
contact and he agrees. When he puts his penis into my arse, our sex and love
are more substantial. Compared with using a condom, you can feel that sex
without a condom is more exciting. Exempted from the worry of AIDS, the sexual
acts are more enjoyable and exciting. When the intercourse is finished,
sometimes, I find that there is some secretion sticking on my penis. At that
moment, I start to worry whether there is any probability of getting in AIDS.
In fact, under a romantic atmosphere,
you will not think about AIDS. Instead, you will feel safe to have sex with him
as you believe that he is faithful to you. In the gay community, it is common
to have sex without a condom. (Thomas 3, 70/96)
Again
it should be pointed out that relational factors (the desire for increased
intimacy, the belief that one’s partner is faithful) do not act alone in this
account, but are accompanied by other factors both psychological (excitement,
impulsiveness and pleasure seeking) and social (the belief that what they are
doing is not uncommon in the ‘gay community’). It should also be noted that the
decision to engage in unsafer sex is being taken in the context of a awareness
of and concern about the risks involved.
A
similar combination of factors can be seen in the following excerpt:
While we were making love, Y expressed
his strong desire that he would like to cum in my mouth. Since Y was a 'new'
member, besides, I loved Y, and actually I also wanted to try, so I let him. It
felt OK to me, I mean if I love my partner, it wouldn't bother me at all. Of
course there are other things to be considered. Things like: Does he really
love me? How deep is my love for him? What is the chance that I may get AIDS?
Actually, if I love someone, I shall love him whole-heartedly. (Wayne 2, 18/28)
For
most of the diarists, love was strongly associated with trust, commitment and
the removal of all barriers, and often to decreased volition. One diarist
remarked: ‘I think there should be no 'boundary' in love. When love comes, you
can't resist.’ (Terrance 5, 18/19). Love was also associated with some degree
of obligation on the part of the participants when it came to certain sexual
practices. As one writer remarked on his decision to allow his partner to
engage in anal intercourse with him: ‘he was my lover, I had to do that for
him’ (Aaron 2, 182/183). Another diarist said, ‘This is a problem of trust. To
certain degree, in order to show my trust and love, I should allow him to fuck
me. (Thomas 6, 59/60)
While
love was a strong factor in unsafer sexual practices between the partners
within a relationship, it also played an important role in reducing
participants’ inclination to engage in sexual activity with casual partners.
Whenever I see a fishing pond, I like
to go inside and have a look. The only
exception was when I first knew my
lover. Suddenly the fishing pond didn’t seem so attractive. Maybe that's what
they call "the magic of
love". (Wai 2, 9/15)
One
participant even intimated that, although contracting HIV in the context of
‘true love’ might a least have some emotional or philosophical significance,
contracting it outside of this context would be ‘meaningless’:
I am still not afraid of dying. My only
belief is that I can't die without any reason. I can't let a stranger pass his
virus to me. Therefore, I shall never swallow a stranger's cum. (Wayne 2,
35/39)
‘Love’
was a factor in unsafer sex not just for those who had found it, but also for
those who had not, and longed for it so desperately. Many of the participants
portrayed finding ‘true’ and ‘permanent’ love as the major goal in their lives,
and frequently expressed considerable frustration and depression as I result of
not having found a steady lover. Compounding this despair was the perception
that ‘true love’ is difficult to find in the tongji community (or among
MSM in general) and, once found, difficult to maintain (a perception shared by
a majority of questionnaire respondents who either agreed or strongly agreed
with the statement ‘It is difficult for tongji to ‘keep’
relationships’):
I do not know the reason why there is only
sex between gay men. I know that gay men usually have sex first followed
by love. I have been in this community for two years but still have not found
true love. Am I unattractive? Am I too fat or too young? I hope that one day I
can find true love and live with my lover for the rest of my life. I still have
not found the one I love. Therefore I have to search and meet different people
in different places. (Leon 3, 27/36)
The
danger of being in this state of ‘desperate longing’ is two fold. Firstly,
believing that love is difficult to find and to ‘keep’ might lead one to engage
in practices one might not normally agree to if they are perceived as either
opening up the possibility of a steady relationship or ensuring that one which
has developed will survive. Secondly, this state of frustration or despair can
also result in individuals increasing the frequency of casual sexual encounters
(having to ‘search to meet different people in different places’) and the
degree of HIV related risk they are willing to tolerate in these encounters.
More frequent visits to venues like saunas and public toilets were also often
reported as a response to failed relationships. One participant described the
situation this way:
The second reason (for people being
promiscuous) is 'cycling'. When a new member gets cheated emotionally once or
twice, or someone gets cheated several times, no matter how serious they are
about relationships, they will lose faith in their lovers in the end. And these
people will eventually become sex-oriented or become 'playboys'. As a result,
we will end up having more and more 'victims of failed relationship' at first
and more and more 'playboys' in the end. This is how this game goes on and on,
generation after generation. (Wayne 5, 27/35)
Moreover,
frustration and disappointment in love related by the participants often
resulted in a lowering of self esteem and a diminishing of expectations. One
participant commented:
I am quite sure that I don't expect any
return from my sentiment. Things are turning worse and worse. Expectations only mean disappointment. I
once had a lot of dreams about find a long-term love. But, now I have no more
dreams like that. (Peter 10, 3/7)
These
diminished expectations might not only discourage tongji from taking the
‘risks’ involved in seeking a long term relationship with its potential for
providing stability and emotional support (both of which diarists associated
strongly with their ability to avoid the threat of HIV), but might also lead
them to a more cynical attitude towards sex and life in general, and a greater
proclivity to engage in both casual and unsafer sex. As Kippax (1992:103)
points out, ‘the potential negative long-term consequences of 'risky' sexual
behavior may seem of lesser importance to an individual who perceives the
future as anyway being a bit uncertain and unpromising.'
The
role of feelings of ‘closeness and intimacy’ in the degree to which
participants were willing to engage in unsafer sexual activities was not,
however, limited to romantic partners,
but also played a part in many casual encounters. A number of diarists remarked
on how having a special ‘feeling’ ( yau FEEL)
for a partner was among the criteria they used for judging whether or not to
engage in sex with them and what kinds of practices they would allow. This
‘feeling’ was not always associated with the potential for a later romantic
relationship. Sometimes it had more to do with physical attraction or feelings
of affiliation or camaraderie. As de Zwart
and his colleagues (1998) remind us, casual encounters are not devoid of
feelings of intimacy, and these feelings can sometimes be as important a factor
in unsafer sex in these contexts as feelings of love are in more permanent
relationships. Consistent with this, 57.7% of the questionnaire respondents
rated ‘’having a special feeling for my partner’ as moderately to very highly
increasing their chances of having unsafer sex.
3.1.2b Negotiation (Accommodation and Reciprocity)
Along
with the nature of the relationships they engaged in and their feelings about
their partners, another important factor contributing to the likelihood of
participants to engage in unsafer sex was the structure of negotiation within
these relationships and the ways in which feelings and intentions were
communicated and interpreted during the sexual act.
The
negotiation of safer sex was rarely verbal or explicit in casual encounters,
and even in the long-term relationships in which it was discussed, verbal
messages were often indirect and used in conjunction with non-verbal cues
(which sometimes contradicted verbal agreements). Within this mostly silent process of negotiation, a number of
norms seemed to hold true across a wide range of both causal encounters and
encounters in more long-term relationships.
Among
the most common of these norms was the tendency for participants to report
attempts to accommodate the wishes (desires, pleasures) of their partners, that
is, to engage in sexual acts they may not normally have engaged in, or at least
may not have initiated, with partners because they thought (or sensed) their
partners wanted them to. Reasons for this tendency were related to such things
as emotional boding, relative amount of power participants perceived each other
to have, age, degree to which participants were physically attracted to or
aroused by their partners, relative inexperience and the desire to avoid
conflict or to create a positive impression.
It is important to note that, although the degree of accommodation was
often greater in longer-term, romantic relationships, reports of accommodation
were also common in narratives of casual sexual encounters. In the
questionnaire survey, 57.6% of respondents rated ‘wanting to please my partner’
and 55.1% rated ‘my partner insists (on unsafer sex) or refuses (safer sex)’ as
moderately to highly increasing their likelihood of engaging in unsafer
practices.
Closely
related to the notion of accommodation was that of reciprocity, the idea that
if my partner did something for me, I owe it to him to provide the same or
equivalent service in return. Sometimes such agreements were quite explicit.
More often, however, and especially in casual encounters, they evolved tacitly
in the exchange and counter exchange of moves in the sexual session. Among
questionnaire respondents, 42.8% rated reciprocity as moderately to very highly
increasing the chances that they would have unsafer sex.
Not
surprisingly, accommodation and reciprocity played a particularly important
role in long-term relationships, especially those in which power differences
existed. One diarist put it this way:
It is common to have one dominant and
one passive partner in a relationship. The one who is in the dominant position
can have more than one lover or have casual sex and…insist on things like
having sex without using a condom. (Thomas 6, 332/336-575)
In
such unequal power relationships, differences in age between partners was also
seen as an important consideration:
These youngsters usually listen to the dominant
one, even when they request anal sex. (Thomas 3, 1105/1107)
Another
reason for accommodation in steady relationships came when one partner felt he
was unable to sufficiently fulfill the role he thought was expected of him, as
in the example below:
F said once: 'I love other people, but
it doesn't mean that I don't love you! It's like parents who love every child.'
Of course I couldn’t accept it at first, but frankly speaking, F was indeed
very nice to me. Apart from that, F would leave Hong Kong soon to work in
another country. That's why I decided to put up with it. Actually, there was
another reason why I gave in, it was because I didn't really want to let F fuck
me. It's because F was my first man; I wasn't experienced and thought that
fucking was dirty. Of course I did let F have it, but not many times. I felt
that I owed F something, so I let F do whatever he wanted outside. (Wayne 7,
26/37)
The
tendency for participants to focus on their partners’ pleasure, sometimes to
the expense of their own, can also be inferred from the fact that, in the 49
narratives analyzed, authors reported their partner reaching orgasm nearly
twice as much as they reported themselves reaching orgasm. Again, this does not
mean that authors of our diaries ejaculated less than their partners, but that
the story-tellers seemed to treat their partner’s orgasm as somehow more
‘significant’ and worthy of mention.
Sometimes
the norm of accommodation even extended to having sex with people participants
did not want to have sex with, direct rejection in such cases being avoided
with narrators choosing instead to ‘go through with it’ and ‘get it over with’
quickly:
When we were going to have sex, I
discovered that he was not the type of person I wanted. So I finished quickly.
(Terrance 7, 52/54)
I was fucked by the Filipino. Since I
was not happy about him, I came quickly then left. (Yo-yo 8, 53/55)
Like
‘love’, with it’s potential to both increase risk by making unsafer sex within
the relationship more likely, and reduce it, by making casual encounters less
frequent, the dyad of accommodation and reciprocity also played a paradoxical
role in HIV related risk behavior for participants, for, although it made them
more likely to agree to risk practices, it also made them more likely to go
along with partners who introduced risk reduction strategies, even when those
strategies were seen as undesirable or unnecessary (like using condoms for oral
sex).
3.1.2c Perceptions of Partner
Other
relational factors, mainly having to do with participants’ perception of their
partner as for one reason or another to be less likely to be infected, also
played an important role in their decisions to engage in unsafer sex. The two
most frequently mentioned factors contributing to these perceptions were
beliefs that their partner was not promiscuous (based on such things as their
dress, their behavior or their occupation) and their partner’s age.
Several
participants mentioned relaxing safer sex measures when they believed their
partner to be a ‘gentleman’ or one who was not likely to engage in casual sex,
and 59.1% of the questionnaire respondents
indicated that ‘thinking that their partner was not promiscuous’ was
moderately to very highly likely to increase their chances of engaging in unsafer
sex.
Closely
related to judgments about the relative promiscuity of one’s partner, was the
belief that having sex with younger or less experienced people was safer. One
diarist related the following story about one of his friends:
But when he chooses partners, he always
chooses younger ones, teenagers. We wonder why he has this special preference.
In fact, he enjoys sex, at the same time, he is afraid of venereal diseases. So, he chooses young gays
who have a clear background or for whom he is their first sexual partner. He
believes that these sexual interactions are relatively safer and so, he does
not practice safer sex. When he has anal sex, which has a high risk of transmitting
AIDS, he still does not practice safer sex as he knows that his partners
have no diseases. (WY 1-3, 455/465)
This
phenomenon is particularly troubling in light the tendency of younger tongji
to accommodate the wishes of their older, more experienced partners. Among
questionnaire respondents, 52.6% reported a medium to very high probability
that having sex with a younger person would increase the chances that they
would engage in unsafer practices, and 55.7% reported choosing younger partners
as a risk reduction strategy sometimes, often or always.
Finally,
some participants reported using their partner’s race as an indication of their
probable sero-status. One diarist wrote:
I was too scared to think about being
fucked. He was my first and last black gay partner in the past 10 years. This is
because I was told that many black people have AIDS. Therefore I tend to avoid
having sex with black people. Since then I have only had sex with Chinese or
Caucasians. (Yo-yo4, 40/45)
