Qualitative Study of Barebacking Factors Among MSM with HIV at Bandung City Regional General Hospital

Abstract

Human Immunodeficiency Virus (HIV) is a virus that compromises the human immune system, primarily transmitted through sexual contact, needle sharing, and vertical transmission from mother to child. Men who have sex with men (MSM) are a high-risk group for HIV infection, particularly due to risky sexual behaviors such as unprotected anal intercourse, also known as barebacking. Various underlying factors influence the decision to engage in such practices. This study aims to explore the factors that encourage MSM to engage in barebacking behavior. A qualitative phenomenological approach was employed better to understand MSM's lived experiences regarding this behavior. The study involved in-depth interviews with seven MSM participants recruited from a Bandung City, Indonesia hospital. All participants were private-sector employees with a high school educational background, and their ages ranged from 26 to 38 years. Thematic analysis of interview transcripts revealed four dominant themes: (1) limited knowledge about HIV and its transmission, (2) trust in sexual partners, (3) pursuit of sexual pleasure, and (4) emotional vulnerability, particularly fear of being abandoned by a partner. These findings highlight the need for targeted interventions that address not only knowledge gaps but also emotional and relational factors influencing sexual decision-making. Public health programs should consider a more empathetic and inclusive approach to reduce the incidence of risky sexual behaviors and ultimately lower HIV transmission rates among MSM populations..