‘Relapse’ to unsafe sexual behaviour among gay men: a critique of recent behavioural HIV/AIDS research

Abstract

'Relapse' to unsafe sexual behaviour among gay men: a critique of recent behavioural HIV/ AIDS research Abstract Recent studies of gay male sexual behaviour have employed a concept new to the literature in the area. Men who appeared to have adopted safer sex behaviours and are now having 'unsafe' sex in relation to possible infection with HIV are described as having 'relapsed'. In this paper we critically evaluate this concept. Firstly we undertake a methodological critique, looking in some detail at studies which have used 'relapse'. We then provide a conceptual critique, suggesting that the construction of human sexuality implicit in the use of this term is inappropriate to the study of sexual behaviour. Finally, we suggest why a concept such as relapse should appear in the literature on the HIV/AIDS epidemic at this time.

A Phenomenological Investigation of the Experience of Taking Part in `Extreme Sports'

“…Holland et al 1991;Maticka-Tyndale, 1992;Willig, 1995;Flowers, Smith, Sheeran & Beail, 1997) and has challenged a 'relapse' model of sexual risk-taking (eg. Hart et al, 1992). The research presented in this paper aims to extend our understanding of meanings and motivations in relation to risky practices within the context of dangerous sports.…”

Gay Men's HIV Risk Reduction Practices: The Influence of Epistemic Communities in HIV Social and Behavioral Research

“…High risk practices were defined as unprotected anal intercourse (UAI) within a monogamous relationship, UAI between regular partners who always used condoms with other men, and UAI with casual partners. The assertion that gay men were relapsing to unsafe sex provoked sharp international debate (Hart, Boulton, Fitzpatrick, McLean, & Dawson, 1992). The term relapse was seen to imply failure, recidivism, and a return to bad habits.…”

“…The term relapse was seen to imply failure, recidivism, and a return to bad habits. The classification of all unprotected anal sex as unsafe was also seen as particularly problematic, given that much of the UAI classified as high risk appeared to be occurring within monogamous relationships and between men with the same HIV status (Hart et al, 1992). However, for the researchers advancing the relapse hypothesis, any unprotected anal intercourse was problematic; as Stall et al (1990Stall et al ( , p. 1182) then put it, "from a prevention point of view any form of unprotected anal sex is undesirable.…”

Cystic fibrosis adults' perception and management of the risk of infection withBurkholderia cepaciacomplex

“…As Lupton (1995) contends in the context of HIV infection, models of rational behaviour ignore the role of pleasure and unconscious desire in emotional expression. Furthermore, in the same context of HIV infection, individuals who have the power to control their behaviour will not always follow expert advice for emotional reasons (Hart et al 1992). Here the circumstances surrounding segregation may change, leading isolates to judge the risks differently on each occasion.…”