Motivations for bug chasing - Adler School of Professional Psychology

Abstract
This study examines the explicit motivations and goals of individuals who are
intentionally seeking to become infected with the human immunodeficiency virus
(HIV), commonly referred to as “bug chasers.” Although previous researchers
have offered hypothesis as the explicit motivations for gay men to seek out HIV
infection, little is known about how these individuals explain the motivation for
their own behavior. This study examines the archival data of Dr. Bruce LeBlanc,
who surveyed individuals engaged in bug chasing behavior about their
explanation of and meaning given to bug chasing. This study explores the current
hypothesis regarding bug chasing behavior and examines Dr. LeBlanc’s data to
support the theory proposed by this researcher, that individuals are motivated
towards bug chasing as a result of being a member of a marginalized group that
faces social exclusion, discrimination, and stigmatization. This study integrates
the data from research in the domains of barebacking, bug chasing, social
exclusion, internalized homophobia and minority stress and suggests individual
and social factors contribute to a desire for some gay men to seek out HIV
infection.

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CHAPTER 1: INTRODUCTION
The AIDS epidemic hit the gay community devastatingly hard when it
erupted in the early l980’s killing hundreds of thousands and decimating
communities. Gay men were hardest hit, and as a result had to make changes in
their sexual lifestyles to prevent infection. Safe sex campaigns prescribed the
regular use of prophylactics such as condoms to decrease risk of contacting
numerous sexually transmitted diseases and infections, including HIV. Condom
use became a way to save one’s own life and to protect one’s sexual partners as
well. For a number of years activists promoted the call for safer sex as a way to
reduce the spread of HIV and AIDS. However, “after more than two decades of
safer sex messages and tens of thousands of deaths, many gay men are returning
to sexual behaviors more commonly seen before the onset of the epidemic by
having unprotected anal intercourse,” known as barebacking in the gay
community (Shernoff, 2005, p. 33). Barebacking is colloquially known as a
descriptor for engaging in unprotected sex, where no intention is made to use
methods to defend against sexually transmitted diseases or infections, and most
often used in relation to homosexual males. However, barebacking can be
defined as “having unprotected sex, not as an ‘accident’ or a temporal ‘relapse’
but rather a deliberate decision” to have unprotected anal intercourse (Baumeister,
2004, p.2). Thus, barebacking is notable given it is considered deliberate and
intentional, and contradicts what is often prescribed in the context of non-

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monogamous or serodiscordant sexual partners. Moskowitz and Roloff (2007a)
summarize research that suggests that barebackers have “deliberately created their
own culture in which men bond over, and value unprotected anal intercourse as a
primary and important construct representing exclusivity, defiance, and
unadulterated pleasure,” (p. 349). Barebacking is an identity not just a behavior.
Some researchers have made efforts to differentiate between barebacking
behavior between monogamous partners, where there is less risk involved if both
partners have been cleared of having a sexually transmittable illness, and those
individuals who bareback in causal encounters without knowing or caring about
their sexual partners’ relevant sexual and health history. This creates a distinction
between those engaging in low risk partnered sexual expression with those who
are engaging in high risk sexual behavior. The implications of barebacking
without knowledge of one’s partner’s health status can be far-reaching and
dangerous, with the most dangerous consequence being the acquisition of HIV.
As concern grew in both the media and the gay community regarding the
impact of bareback sex, a new form of high-risk sexual behavior emerged in the
mid l990’s in the form of bug chasing. Bug chasers are “physiologically healthy,
HIV-negative gay men [who] appear to be actively seeking seroconversion by
engaging in unprotected sex with HIV-positive partners” (Moskowitz & Roloff,
2007a p. 348). Bug chasers often attempt to get infected with HIV through
unprotected sex, which is technically considered barebacking. However, the

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distinction between barebackers and bug chasers is clear: not all barebackers are
bug chasers, however most bug chasers are barebackers. The difference lies in
intention. Barebackers are at risk for becoming infected with HIV as a result of
unprotected sex; however, this motivation is not clearly and specifically noted in
identity, whereas bug chasers identities are based on their desire to seroconvert.
For bug chasers, the purpose of engaging in unprotected sex is to become infected
with HIV, whereas barebackers do no share in this explicit motivation. Bug
chasers appear to seek HIV infection for a number of reasons that will be explored
in the following research.
Barebacking and bug chasing are both behaviors that can be classified on
the spectrum of high risk sexual behaviors. This is especially true when
contextual factors such as health and infection status of one’s partner are not
explicitly addressed. However, bug chasers are engaging in the behavior not as
passive barebackers who are not invested in a specific outcome, but rather
identify as bug chasers precisely because of a desire to become infected with HIV.
An additional segment of individuals often included in conversations about bug
chasers is gift giving. “Gift giver” is a term commonly used to refer to HIV
positive individuals who engage in sexual behavior with HIV negative people in
an attempt to give them the “gift” of HIV.
Moskowitz and Roloff (2007a) suggested approximately 14% of gay men
engage in barebacking (p. 348). This differed substantially from research done by

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Nimmons in the 90’s which found the proportion of gay men “primarily behaving
safely, [which means different things in different studies, but tends to equate
somewhat misleadingly with using condoms] commonly hovers between 60 and
70 percent” (as cited in Halperin, 2007, p. 13). No estimate exists for how many
individuals engage in or identify as bug chasers. Halperin (2007) noted the
percentage of heterosexual men and women practicing safe sex is often less than a
third of the sample. Halperin (2007) reviewed statistical and demographic
measures of gay men, and reported “nearly 90 percent of all HIV-negative men
who have sex with men in the United States continue to avoid unprotected anal
sex with potentially HIV-positive men” (p. 18). Clearly there are differences in
the way researchers and participants understand and define safety in regards to
sexual behavior. The research suggests bug chasing is a real phenomenon,
however estimates are not clear as to how many people who claim to be bug
chasers actually engage in seeking out HIV compared to those that use the
concept as a fantasy. It is also important to note that the controversy regarding
barebacking and bug chasing are addressed only in the context of men who have
sex with men (MSM). The question remains as to whether or not barebacking and
bug chasing behavior exist in non-gay individuals.
Bug chasers often seek gift givers to infect them with the HIV virus, and
commonly do so through the use of the Internet. Dew and Chaney (2005) wrote
“the anonymity, affordability, and accessibility of the Internet make it

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increasingly inviting for those individuals whose sexual attraction is towards
individuals of the same or both genders. Due to the stigmatization associated with
non-heterosexual orientation, the Internet allows gay and bisexual men the
opportunity to express their sexuality without fear of persecution” (p. 260).
However, it appears only a small number of barebackers who use the internet to
find partners do so with the intent to spread or receive HIV. Thus, there appears to
be a distinction between barebackers engaging in condomless sex for the goal of
HIV exchange, and those who do it to serve another purpose. Shernoff (2006)
noted most men who meet other men on-line for sex are open to taking sexual
risks, “it is only an infinitesimally small percentage who actively seek to become
infected or infect another person. This is a subtle but important distinction” (p.
157). In his own search for finding individuals seeking to become infected or
infect someone else with HIV, Shernoff (2006) found “that while the bareback
websites are filled with thousands of men seeking unprotected sex, only a very
small minority are actually consciously seeking to either get or spread HIV or
state this online” (p. 159). Thus, it is only a small percentage of men who are
deliberately and explicitly seeking to become HIV positive through bareback sex.
This distinction suggests that barebackers may have an unconscious or conscious
attraction to unprotected and thus high-risk sex; however becoming HIV positive
is not the explicitly stated goal or motivation for the bareback sex. Bug chasers,
on the other hand identify as such precisely because of their desire to become HIV

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positive, and not just to engage in bareback sex for reasons of sexual pleasure or
excitement.
This study will explore the research that has been done on bug chasing
behavior and propose an alternative hypothesis integrating the impact of social
exclusion, discrimination and rejection on the desire to become infected with the
HIV virus. Furthermore, the archival data of Dr. Bruce LeBlanc, who surveyed
individuals engaging in bug chasing behavior regarding the motivations and
explanations for their desire to seek out HIV, will be used to support this
researcher’s hypothesis. It is clear that human behavior and motivation are highly
varied and not defined by a single factor. Thus, this researcher does not suggest
social exclusion is the single cause of bug chasing behavior, but rather, a
contributing factor to the behavior that needs to be addressed for effective
prevention and treatment.

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CHAPTER 2: LITERATURE REVIEW
Almost as quickly as bug chasing behavior began being discussed by
journalists, activists, lay people, and members of the homosexual and
heterosexual communities, social science researchers put forth theories explaining
the goals and motivation of the behavior. Most researchers studying individuals
engaged in bug chasing behavior offered common sense and seemingly credible
explanations regarding the motivation for seeking HIV infection. These theorists
offered supportive psychological and public health theories addressing the
motivation for bug seeking. Additionally, researchers also examined the
demographics and behavioral patterns of bug chasers. Through this research a
common understanding of the common features of individuals engaged in bug
chasing was developed.
As mainstream media and academic researchers intensified their
discussion and hypothesized explanation of bug chasing behavior, some groups
began to dispute the existence of a bug chasing culture. Moskowitz and Roloff
(2007a) created a study that examined the authenticity and strength of a distinct
bug chasing phenomenon through the analysis of personal profiles posed on
bareback.com. Their sample showed 33% of the identified bug chasers were
actively searching for HIV positive partners and labeled ardent chasers, while
66% of the identified bug chasers were had a preference for partners who were
potentially positive, and labeled apathetic chasers (p. 355). They also found bug

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chasers could be viewed as distinctively different from barebackers and have a
separate, although similar, subculture (Moskowitz & Roloff, 2007a). Their
research solidified the concept of bug chasing as a real phenomenon with distinct
characteristics separate from barebackers.
Other researchers have investigated the bug chasing phenomenon and
attempted to explain the purpose and meaning of bug chasing behavior. However,
little research actually sought to understand the bug chasing behavior from a
phenomenological perspective. Thus, the current hypotheses describing the
purpose of bug chasing became an assumed explanation, without a direct
assessment of the individual perceptions, motivations, and values of the meaning
of bug chasing and how they understand themselves and their own behavior.
Although researchers have offered logical and theoretically sound explanations
for bug chasing, they are incomplete until they have been infused by research
investigating the motivations and thoughts of the actual individuals engaging in
bug chasing behavior. Thus, it is first necessary to address the common theories
that seek to explain the dynamics of individuals seeking out HIV.
Current Hypotheses for Bug Chasing
Gautier and Forsyth (1999) suggested four overlapping “lines of
explanation” for understanding bug chasing behavior. Although it is easy to
parcel out motivations for bug chasing into four distinct categories for research

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purposes, human behavior is far more complicated and enmeshed than these
distinct categories suggest. It is likely that for most individuals a collaboration of
the categories suggested can offer a better understanding and explanation of
individual human behavior. The four proposed explanations researchers often cite
as the motivation and explanation of bug chasing include the following themes:
fear and relief, risk taking as eroticism, loneliness and group solidarity, and
political actions (Gauthier and Forsyth, l999).
The fear and relief model suggests individuals who bareback seeking HIV
often cite their reason pragmatically. Based on this reasoning, a bug chaser views
infection as inevitable and seek out HIV instead of waiting for possible infection.
Bug chasing then becomes a way to deliberately liberate oneself from the fear
and anxiety of waiting, and in turn reclaiming a sense of power and control in the
seroconversion instead of being a passive victim of chance. This theory suggested
that by seeking out HIV, bug chasers are attempting to empower themselves in the
inevitable face of infection. The theory surmised that bug chasing reframes the
process of seroconversion into an empowered shift into power and control of
eventual infection. The owner of barebackjack.com described this phenomenon
and his impressions of why men bareback by stating:
The first one is one of resignation. Most of the men I have talked
to indicated they wanted the fear of being infected over and done
with. This attitude is consistent in men who bareback as well as

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practice safe sex. The barebackers are tired of worrying after
every encounter if this was the fuck that might convert them. The
routine condom users are tired of fearing the likelihood of a torn or
punctured condom. Fear has been a very powerful motivator
throughout the AIDS crisis, and it has also been capitalized on.
Some people are simply tired of living their lives in fear when they
so desperately want to enjoy sex without fear. These men don’t
see any other way of releasing the fear of HIV other than by
resigning to the virus (p. 165).
The psychological implications of bug chasing as a mode to
empowerment are far reaching. The idea of HIV as eventual and bug
chasing as a form of reclaiming one’s power to the inevitable likely
decreases in individual’s sense of being a victim to chance and
circumstance, and instead produces a sense of overt strength and lack of
fear in the face of perceived inevitable infection. The question remains
however, if one is only seeking out HIV to prevent being a passive victim
to HIV, why not utilize HIV prevention strategies, such as the use of
condoms as a way to assert power or control? Furthermore, this theory
does not explain how such a high level of anxiety about getting infected
transforms into a desire to actively seek out the source of the anxiety.

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Bug chasing has also been described as a way to bring the fun back into
sex, decreasing the constant reminders of the possible danger of sex through
condom usage and vigilance about safety. Freeman (2003) explored this idea, and
used a found an individual who explained how, “getting HIV will make safe sex a
moot point…. It’s about freedom. What else can happen to us after this? You can
f*** whoever you want, f*** as much as you want, and nothing worse can
happen to you. Nothing bad can happen after you get HIV” (p. 4). According to
this theory, the inhibition created by safer sex practices is so cumbersome that
seroconversion becomes a way to free oneself from the rigor required for HIV
infection prevention. Getting HIV does not, as the man in Freeman’s article
believed, create a worry free lifestyle in regards to HIV. For those who are HIV
positive, barebacking can lead to: “‘superinfection,’ rapid loss of CD4 cells,
especially through continual ejaculate exposure, and risk for contracting other
STDs that may lead to opportunistic infections such as Kaposi’s sarcoma, coinfection
with hepatitis C, and immune system deterioration” (Halkitis, Parsons &
Wilton, 2003, p. 352). Counteracting the belief that an HIV positive diagnosis
means no longer having to worry about infection and offers freedom to engage in
unprotected sex with other infected individuals is important to preventing bug
chasing behavior as a form of anxiety relief. The belief of bug chasing as a way
to take control over a scary or inevitable situation are steeped in the belief that
having HIV is better than the fear of the possibility of getting it. This thinking

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may suggest a sense of a desire for power in conversion and strong discomfort in
being a passive victim. Following this theory, through bug chasing a person
reclaims power and decreases the anxiety felt about inevitable infection.
Other theorists have suggested condomless sex, through barebacking or
bug chasing, is erotic precisely because it is dangerous. Mixing sex with danger
to create a heightened sexual experience is far from rare and occurs in numerous
forms. Compared to barebacking, bug chasing is the more extreme version of this
urge. In barebacking the risk of infection is possible given a partner’s HIV status
may not be discussed, whereas bug chasers face an even greater risk/turn on in the
knowledge that a sexual partner is HIV positive and can infect them through
sexual activity. Sexual desire and behavior both have cultural and biological
influences. Crossley (2004) suggested that desire is formed within a cultural
context. It is through implicit and explicit socialization, younger members are
taught what is permissible and what is considered taboo, which often results in
missed feelings regarding shameful desires. What often occurs is that which is
forbidden becomes the object of desire and pleasure. Barebacking behavior for
some, seeks to heighten the sexual experience by introducing risk. Grove (2006)
suggested these individuals are not necessarily bug chasers, but rather individuals
who “engaged in risky behavior because they found it erotic,” (p. 6). Thus
unprotected anal intercourse is reframed from a dangerous behavior to one that is
eroticized because of the inherent danger.

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Other theorists have also suggested that sexuality that is transgressive can
be highly erotic. Shernoff (2005) noted “for men who once relished their selfimage
as sexual outlaws [due to an awareness of same-sex attraction],
barebacking became one way to do something that is considered transgressive” (p.
35). Rofes described his own experience of the eroticization of the transgressive
noting:
Anal sex crept into my life slowly during the l980’s. Repeated
cultural messages telling me to ‘Wear a rubber every time’ and
‘Use condoms-100 percent; may have heightened my interest in
f***ing and created powerful new meanings of anal sex for me.
As f***ing and getting f***ed asserted themselves in my
daydream, I wondered whether my own desires emerged from
transgression? Was the now forbidden nature of anal sex sparking
new desires within me? Did I want to f*** guys because it was
dangerous?
Was there something about illness, death and
prohibition that got me hard? (Rofes, as cited in Crossly, 2004, p.
236)
The behavior is placed in a historical context given the oppression gay men have
faced as a result of their same-sex sexual desire.
Rofes described how,
“transgression is doing what one is told not to do. Historically, where a rule has
been laid down forbidding men from living their sexuality openly, homosexuals

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have always found ways to circumvent that prohibition” (Rofes, as cited in
Crossley, 2004, p. 235). The implications of this perspective are highly relevant
for those interested in harm reduction techniques. Rofes astutely predicted a
backlash against HIV prevention work given the propensity for prohibited sex to
become attractive. It is possible to see barebacking and bug chasing behavior as
sexually charged precisely because of the illicit nature of engaging in
transgressive sex. Desiring HIV pushes this boundary even further, given the
danger of seeking out a sexually transmitted disease. Thus, bug chasing can be
viewed as a counterintuitive sexual enhancement strategy. Bug chasing based in
the motivation of an attraction to the illicit creates complicated issues for
prevention and treatment providers.
Another theory proposed to explain bug chasing behavior is based on the
notion that individuals seek out HIV in an attempt to combat loneliness and to
become part of a community. An individual who seeks out HIV to become part of
a community no longer has to feel alone, and by seroconversion, joins a
community and thus finds a place of belonging. Additionally, by embracing the
identity of bug chaser a person becomes part of a group by embracing the bug
chasing identity. As described earlier, bug chasing exists as a identifiable culture
and has it’s own group identity, with common language and behavior. Group
belonging develops prior to seroconversion as an individual takes on the identity
of a bug chaser. Thus identity as a part of a group develops in both the idealized

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idea that one will be embraced once they seroconvert, as well as through joining
the bug chasing community. Grov (2006) described an anecdotal example of how
one individual explains the benefit of joining the bug chasing community: “At last
I feel part of a thinking, feeling, ever growing community instead of some sexual
deviant or outcast” (p. 1). Often times, individuals interested or engaged in bug
chasing seek out others through the internet.
Given bug chasers strong use of the internet to find a sexual partner to
infect them with HIV, it is imperative to address the role the Internet has played in
bug chasing behavior within the gay community. Grov (2006) wrote:
Researchers have linked the Internet to both unsafe sexual
behavior among MSM (men who have sex with men) and to the
rise in barebacking…. The Internet, and specifically websites
devoted to barebacking, has also been connected to the emerging
phenomena of gift giving and bug chasing (p. 2).
It is through the internet individuals connect with others involved in the
group identity. It should be noted that bug chasing behavior appears to be
largely, although not entirely facilitated through the internet.
The internet and online dating websites are mediums that allow people to
seek out their fantasies anonymously, and without the fear of judgment.
Additionally, research done by Halkitis and Parsons (in Shernoff, 2006, p. 108)
noted:

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It is easy to find sex partners who want to bareback on the Internet.
Participants in this study explained that because the Internet is
anonymous, they are more likely to use it to look for sexual
partners who want to bareback, and they are likely to succeed in
finding other men into barebacking on the Internet because it has
become commonplace for online profiles to include HIV status.
In addition to finding a sense of community among the bug chasing community
on the internet, bug chasing can be seen as an attempt to find a sense of place and
belonging within the HIV positive community. Gauthier and Forsyth (1999)
described how:
Many HIV negative gay men feel that they have been left behind as lovers
and friends have moved on to a status they do not share. The loss of
solidarity and sense of community is overwhelming, particularity for
individuals ensconced in a nation already divided along heterosexualhomosexual
lines. Now there is a further split within the homosexual
community between those who are HIV positive and those who are HIV
negative” (p. 94).
Seroconversion becomes a ticket into an exclusive group, whose members are
often cared for by the larger community. Those who engage in bug chasing
behavior appear to be looking for some source of identity, and find it in the
context of bug chasing. As communities rally to support and offer services to

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people with HIV and AIDS, it is easy to see that for those lacking a sense of
belonging and connection the negative aspects of acquiring HIV are not strong
enough deterrents as the community support that can be gained. The theory
implies getting HIV becomes a way to belong to a larger community, even if it
means living with a chronic illness.
Another theory related to the “attraction to the transgressive” extends this
idea by connecting barebacking and bug chasing behavior as a form of resistance
against the dominant heteronormative culture. Gauthier and Forsyth (1999)
explained this concept when they stated:
Bug chasers behave in this way because they see the behavior as a
politically charged action in response to the larger homophobic
culture that has stigmatized gay individuals [and gay sex] as a
whole and especially HIV-positive gay individuals as outcasts” (p.
95).
Crossley (2004) further described how bug chasing is a response to negative
attitudes toward men who have sex with men. As a result, she concluded:
The embodied sexual activities associated with male culture are
also testimony to the rebellion and ‘transgression’ of ‘polite’
sexual activity. Multiple sex partners, cruising, anonymous sex in
dark, ‘dirty places,’ ‘intentional’ acts of risky ‘barebacking’-All of

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this bears the hallmark of resistance to dominant heterosexual
norms and mores (p. 239).
From this stance, bug chasing can be viewed as a way to assert feelings of power,
with behavior that implies the individual is not going to be imprisoned by the
restrictive expectations implied in the constricted heternormative, and thus
implicitly homophobic culture. Thus, “the discrimination and more disdain to
which gay men are subjected are viewed by some bug chasers as forces that
literally push them to respond in such a politically charged way” (Gauthier and
Forsyth, l999, p. 95). This theory posits that bug chasing is a political tool used
against the dominant heteronormative culture. This differs from my theory which
sees bug chasing as a reaction to discrimination and social exclusion, but not as a
political tool. It should be noted that power dynamics between sexual partners is
also a factor that contributes to bug chasing behavior. For example in couples
that are serodiscordant, the HIV-negative partner may attempt to seroconvert as a
way to prove one’s devotion or commitment to their partner. Additionally, for
individuals who do not have the confidence to be assertive with their sexual
partner/s negotiating safer sex practices may be difficult. Although this is not
intentional bug chasing, it may result in HIV infection.
Community advocate Dan Hill (2000) proposed a generational paradigm
for understanding bug chasing behavior. In his article he makes a distinction
between generations of individuals who engage in bug chasing. He noted, “the

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older generation are those that have lived through nearly two decades of loss and
grief due to the ravages of HIV” while “the younger generation of gay men [who]
have not been as affected by the multiple losses which have occurred in our
community” (2000, p. 3). He made it a point to discuss how the intention of
individuals seeking out HIV can be both conscious and unconscious, with the
motivation for the behavior existing outside of one’s explicit awareness (2000).
Hill believed bug chasers of “the older generation of gay men may possibly be
suffering from post traumatic stress disorder” after witnessing the deaths of
friends, family, and others in their extended community (2000,). Hill also
suggested guilt about not getting infected with HIV, when so many other people
close to them have, is a large factor in the motivation for seeking out HIV. Based
on this notion, he presents bug chasing as a symptom of PTSD. Hill described
this process when he described how he can:
Recall some men who were HIV- in the late eighties attending
support groups where they openly expressed their hopelessness
and alienation as they witnessed their friends, their peers, and
their generations die. I have witnessed many such individuals
express disappointment and despair that they were still alive. I
have heard men say it would have been easier to die with the
complications of AIDS because living meant having to cope with
multiple loss (Hill, 2000, p. 4).

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Hill offers a unique perspective that puts bug chasing behavior in a social and
historical context. Framing bug chasing through a trauma paradigm, one can see
how bug chasing may be an attempt to compensate for the trauma of losing
members of one’s own community. This perspective not only removes much of
the stigma associated with the bug chasing, it also reframes it as a maladaptive
coping mechanism a person utilizes to deal with the emotional trauma or
surviving, versus an individual character flaw or personal shortcoming. The
implications of this framework, when appropriate, are of particular relevance
given the large amount of trauma therapies currently available. Therefore,
reframing bug chasing as a re-experiencing of repeated trauma, as a PTSD
reaction may offer opportunities for creating more effective preventative and
treatment options. From this researcher’s perspective understanding the impact of
discrimination and multiple losses may decrease the pejorative labels bug chasers
often get as a result of their maladaptive coping behavior. Moving away from a
model of bug chasing as deviant will likely improve this outcome.
Shernoff also addressed the generational issues related to barebacking and
bug chasing behavior by looking at the generation of gay men who were not born
or yet sexually active during the when the AIDS epidemic emerged. Blechner
described this generation difference and perspective and behavior when he noted:
Young men today may be lucky not to have lived through the
terrible times of the early days of the AIDS epidemic, but

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consequently, many such people do not share the great sense of
relief that the previous generation felt at being able to stay alive by
mere condom use. Some instead feel resentment and deprivation
at the constraints of safer sex (in Shernoff, 2006, p. 107).
According to this hypothesis, the generation of gay men who became sexually
active after the AIDS crisis hit, perceive themselves as missing out on an having
the opportunity to have uninhibited sexual adventures, free of the threat of illness
and infection. Instead, this theory proposed this younger generation is dealing
with a sense of loss because they came of age in a time where sex was tainted
with danger and disease. Shernoff (2006) addressed this issue, stating:
Gay men who became sexually active when AIDS was already a
reality grew up reading about and hearing how different gay sex
was before the onset of the disease.
For many a sense of
impractical romanticism has developed about how wonderful and
liberating sex used to be ‘in the good old day (p. 107-108).
This romanticism, real or perceived, of the way sexuality was able to be explored
before HIV and AIDS lead some later generations of gay men to feel cheated in
out of the sexual freedom that existed after Stonewall and before the AIDS
epidemic. Shernoff described how for the post AIDS generation feeling a sense
of nostalgia for the way they believe things were before AIDS, “has become
oppressive; they feel subjected to conscious and unconscious comparisons of how

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the sex they are having falls short of the sexual experiences that men used to have
without worry, thus contributing to their desire for unprotected sex” (Shernoff,
2006, p. 108).
One of the most common beliefs cited about the danger of HIV is that it is
easy to manage and that it is no longer life threatening (Crossley, 2004; Shernoff,
2005). The shift of seeing HIV as no longer being a deadly illness, and instead a
minor annoyance has also been seen as a factor contributing to barebacking and
bug chasing behavior. For one individual who was seeking out HIV, he described
how he believed life would be like once infected “it’s like living with diabetes.
You take a few pills and get on with your life” (Freeman, 2003, p. 2). Thus, for
those individuals who see becoming HIV positive as an entrée into a community,
the benefits of becoming HIV positive outweigh the mild and manageable risks.
A large part of this shift is explained by the creation and proliferation of HIV
antiretroviral therapy. Shernoff (2006) suggested that although antiretroviral are
helpful to those who need them, they “provide gay men with a misplaced sense of
complacency” (p. 107). His hypothesis is based on research that found an
“increase in high-risk sexual behavior is connected to the advent of combination
antiretroviral therapy” (Shernoff, 2005, p. 35). It appears antiretroviral therapies
have decreased the fear once associated with HIV in offering a needed treatment
for some. However individuals may be becoming lax in their HIV prevention
strategies, such as using condoms, believing they have a safety net of

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pharmocotherapies that will mediate the symptoms of HIV. In the case of those
who engage in bug chasing behavior, the secondary gains to having HIV are
worth what they believe are minor costs. Thus, the improved effectiveness of
antiretroviral and other pharmacotherapy has improved the lives of thousands of
people living with HIV; however, it has also decreased the perceived lethality and
fear of the virus, leading to a decrease in condom use and sexual infection risk
reduction.
Although a great deal of progress has been made in regards to improving
the effectiveness of HIV pharmocotherapies, there are still a number of negative
effects as a result of living with HIV infection. Grov and Parsons (2006) noted
individuals can be infected with more than one strain of HIV, further
complicating and reducing the effectiveness of treatment. However, the myth
exists that once you get HIV you no longer have to worry about safe sex as long
as it is with other HIV positive partners. For those individuals who intentionally
do not use condoms and engage in bug chasing behavior, it is important to counter
the message that once an individual becomes infected with HIV, they will only
face minor medical inconveniences and be given the freedom to engage in any
kind of sexual behavior they desire. While it is the role of the community and the
care providers to acknowledge the increased ability to manage HIV through
medications, nutrition, stress-management and other self-care techniques, it is
essential to highlight that HIV can still become a debilitating and terminal disease

25
resulting in physical, neurological, and emotional consequences that are often
difficult to treat. Furthermore, the side effects of many HIV medications are often
said to be as difficult as or more difficult to cope with than HIV itself. For many
bug chasers, the fantasies they have about life after HIV infection are remarkably
different than the reality. However, for many individuals engaged in bug chasing
behavior the perceived short-term benefits override fears about long-term
consequences.
The increased effectiveness of HIV medications is not the only way
pharmocologies have impacted high-risk sexual behavior. Improved management
of HIV symptoms through pharmocotherapies has led to a reduction in fear of
contracting HIV. One factor discussed is the impact medication advertisements
have on decreasing the fear of contracting HIV, and seeing it as a debilitating
illness. Shernoff (2005) noted, “thanks to highly active antiretroviral therapy and
improved prophylaxis that prevent most of the AIDS-related opportunistic
infections that once were invariably fatal – along with testosterone, human growth
hormone, steroids, and weight training – people with HIV can be imposing,
muscled hunks” (p. 35). What Shernoff described is often the effects of
medication prescribed to prevent the wasting syndrome that often accompanies
HIV treatment. For someone who is feeling weak, physically or emotionally,
these benefits become a way to enhance bulk and appear powerful and strong.
Additionally, the use of attractive and physically fit models for HIV

26
pharmotcoherapies has also been implicated in the connection between HIV and
attractiveness. In his 2005 research Shernoff addressed this topic by stating:
For several years now, advertisements run by pharmaceutical
companies for antiretroviral drugs have pictured robust and buff
young men (and women) engaged in strenuous physical activity
like climbing mountains or sailing. These visual representations
reinforce the notion that HIV is no longer a life-threatening or even
serious condition (p. 35).
Thus, individuals may internalize the message that HIV is manageable and can
have benefits such as enhancing strength and sex appeal. However, the use of
attractive and sexually appealing models in HIV medication advertisements has
had positive effects on the HIV positive community by decreasing the stigma
associated with being HIV positive. Thus, HIV is no longer synonymous with
images of people who are sick, dejected, weak, and dying. Clearly advances in
HIV medications should be applauded and continue to be important for helping
those individuals who are already positive live more healthy and functional lives.
However, unintended consequences have occurred, including decreasing the fear
associated with infection. Furthermore, for those individuals attracted to aspects
associated with seeking out HIV, the benefits of improved drug treatments has
paved the way for engaging in high risk sexual behavior because the risk appears
to have been minimized.

27
Research on Motivation for Barebacking
The research on barebacking is especially useful when trying to
understand the motivation for bug chasing behavior. It is likely these factors are
also contributors to the desire to engage in bug chasing behavior. There are other
theorists who have suggested a desire to engage in barebacking behavior stems
from an attempt to create intimacy by removing the physical barrier, such as
condoms, between people engaging in intercourse (Crossley, 2004; Halkitis et al.,
2003). Crossley (2004) suggested how “unsafe sex [can be viewed] as an
expression of love and intimacy” (p. 226). Thus, a person may believe condoms
provide a barrier both physically and emotionally from one’s partner, and by
removing the condom, there is no longer a physical representation of a barrier. A
person’s willingness to engage in unprotected sex may also serve to show a
partner their devotion or commitment. From this view point, barebacking
behavior is seen as obvious risk, but it is exactly the risk and the person’s
willingness to engage in it that becomes a way to testify a level of trust, love, or
devotion. Halkitis, Parsons and Wilton’s (2003) research suggested “gay and
bisexual men perceived numerous psychological and emotional benefits
associated with barebacking, including but not limited to feelings of
connectedness, intimacy, and masculinity” (p. 355). The desire to seroconvert
has also been explained by those who feel seroconverting will allow them to share
HIV-positive status with their partner. For those that seek out HIV to enhance

28
trust and commitment to a partner, it is thought they are willing to give up their
life for their partner. Thus it appears likely some individuals engaging in bug
chasing do so as a way to prove intimacy and love. Furthermore, by removing the
condom, the physical barrier is removed and for some, an enhanced physical and
emotional intimacy can be achieved.
Theorists have also suggested the motivation for barebacking behavior is
rooted in individuals internalizing the homophobic attitudes present in society.
As a result, individuals develop a sense of self, fused with shame and believe they
deserve HIV infection and harm as a punishment for their same-sex desires.
Shernoff (2005) addressed the role of internalized homophobia connections to
barebacking behavior when he stated how “internalized homophobia can
contribute to barebacking by creating an unconscious sense that a gay man is
unimportant and undervalued, thus increasing his sense that he is expendable, and
so too are them men with whom he has sex and from whom he seeks love and
validation” (p. 106). From this perspective it is possible to see how homophobia
continues to have dangerous consequences, from individuals acting violently
towards GLBT people to GBLT individuals internalizing those negative beliefs
and acting violently towards themselves. Gauthier and Forsyth (1999) connect
this to Lemert’s theory of secondary deviance, and explained how “stigmatized
individuals come to accept as part of their self-image the public designation of the
pejorative label. On acceptance, individuals then go on to fulfill the negative

29
prophecy” (p. 95). Hill’s (2000) theory of bug chasing as a form of self injury
follows within this paradigm. In his theory, Hill (2000) described how he
understands the impact of internalized homophobia on bug chasing behavior:
I believe many gay men experience a great deal of internalized shame and
anger through awakening to, and acceptance of, their sexuality in a
homophobic society. The resulting Self Injurious Behavior paradoxically
provides an individual with an opportunity to nurture himself, ‘to make
internal would external and to nurture and heal these wounds…it is much
easier to take care of a visible, tangible wound [or medical condition such
as HIV] than to care for internal or emotional damage (Hill, 2000, p. 8).
Barebacking and bug chasing behavior can thus be conceptualized as
stemming from an internalization of homophobia and heterosexual norms and
resulting in the acculturation of homophobic attitudes.
One of the more recent theories proposed by Moskowitz and Roloff
(2007b) suggested bug chasing is a symptom of sexual addiction. They refute the
theories intimated by other researchers, and highlight the similarities of bug
chasing with other sexual addiction behaviors. Regarding the idea of bug chasing
as a way to become part of the community they question why an individual would
need to engage in such risky behavior when there are other ways to find affiliation
within the HIV community such as becoming an advocate or caretaker. They also
addressed the idea that HIV is now considered sustainable and manageable

30
disease noting, “this explanation only suggests that individuals should be
indifferent to a partner’s serostatus rather than exclusively seeking HIV-partner,”
(p. 23). Moskowitz and Rollof (2007b) argued against the idea of a
“psychological reactance effect” such as a protest against safer sex campaigns,
noting it does account for why some men do not practice safer sex, but still does
not fully address why bug chasers actively seek out serodiscordant partners. They
negate the concept of bug chasers seeking out control in their seroconversion due
to the inevitability of infection by labeling it as an “inconsistent processes”
whereby “such fatalism is more likely to produce a sense of helplessness which
lead to indifference about safe sex practices and partners’ HIV status rather than a
desire to become infected” (p. 24). Moskowitz and Roloff (2007b) sought to
distinguish if a difference existed between barebackers and bug chasers. Their
research found bug chasing was a part of sexual addiction as defined as: engaging
in persistent and escalating patterns of sexual behavior acted out despite
increasing negative consequences to self and others (The National Council on
Sexual Addiction and Compulsivity as cited in Moskowitz and Roloff, 2007b, p.
24). Following this definition, they conducted research and found bug chasers
were more sexually passive and reported a larger interest in partner’s who
identified as sexually aggressive relative to barebackers. They explained how a
voluntary power inequity inherent to bug chasing and this serves as an aphrodisiac
necessary for sexual excitement. Moskowitz and Roloff (2007b) explained how,

31
“chasing becomes the ultimate expression of subjugation, humiliation, and
passivity-all of which are simply not voiced by the bareback community, all of
which are incredibly arousing for chasers” (p. 35). These authors also found bug
chasers differed from barebackers in their desire for submissive forms of
paraphilias and fetish-like behavior. Regarding the degree to which the bug
chasers and barebackers differed in regards to sexual addiction, they reported
30.6% of bug chasers were significantly more likely to self-humiliate than the
13.3% of barebackers who reported use of self-humiliating language (p. 33).
They also found 35.8% of bug chasers reported an explicitly stated need for sex,
and/or being addicted to sex, while only 24.7% of barebackers reported the same
need (p.33). Overall, they suggest bug chasers do not engage in the bug chasing
for reasons of belonging, a sense of HIV as livable, a reaction against safe sex
campaigns, or a desire to control the contraction of HIV, but rather symptoms
associated with sexual addiction.
It is likely that many of the above theories dance together in a complex
interplay influencing an individual’s desire to seek out HIV infection. Like all
human behavior, there is a high probability that multiple individual and social
factors contribute to identity and motivation. However, there appears to have
been a lack of direct assessment of the individual motivations of the population
being explored. Furthermore, perhaps too much blame is being placed upon
individual factors while ignoring the larger social and systemic issues. Therefore,

32
this research study attempts to assess bug chasers’ explicit and conscious
motivations for HIV infection. Although it is likely some unconscious dynamics
play a part in bug chasing behavior, the individual’s conscious beliefs and
motivators are of great importance for continued research, prevention, and
treatment. Furthermore, the impact of social exclusion has been ignored in the
current theories, and is a necessary lens through which to view the high risk
sexual behavior of bug chasing.
It appears necessary to investigate the conscious motivational factors
underlying bug chasing behavior to better understand what, if anything, should be
done both in the public health domain and psychotherapy field regarding
individuals seeking HIV. LeBlanc (2007) sought to understand these issues in a
study done investigating the social and psychological dimensions of bug chasing.
He described a need for research investigating the sociological and socialpsychological
perspective of the bug chaser, without a researched imposed theory
of deviance. Regarding this topic Leblanc wrote “to frame such behaviors as bug
chasing as inherently deviant without a direct assessment of the behavior and
behavioral motives from individuals engaging in this practice is intellectually
wanting and academically questionable” (p.13). This study attempts to explore
the explicit motivations for bug chasing from individuals engaging in the
behavior. Additionally, this researcher will integrate the research on social
exclusion as a factor influencing individuals toward bug chasing.

33
Social Exclusion Literature
The commonality among the proposed theories described previously in
this work is the notion of bug chasing as deviant or based in individual
psychopathology. The current research on the impact of social exclusion offers
data that may be useful for understanding the socio-cultural factors that may
contribute to bug chasing behavior in gay men.
Psychology has a long history of addressing the power of human
relationships and the inherent need of humans to have a sense of interpersonal
connection. Maslow’s motivational hierarchy placed love and belongingness
needs as necessary as esteem and self-actualization (Baumiester and Leary, l995).
Bowlby’s attachment theory is also strongly supported and composed on the idea
that humans need to form relationships, and that individuals can be harmed by a
lack of supportive, empathic relationships. Thus, “human beings rely on group
life for their health, wellbeing, comfort and other positive outcomes. Being
accepted into a social group is therefore an almost indispensable goal of human
striving,” (Baumeister et al, 2005, p. 589). Starting from birth, humans need
connection with others to thrive. A prime example is the failure to thrive
response that occurs when an infant experience severe neglect and is deprived of
necessary human interaction. Human disconnection clearly has an impact on
emotional and physical functioning. Feeling a sense of connection and belonging

34
is necessary for a healthy sense of self and interest in pro-social behavior; sadly,
when groups of people are often ostracized and marginalized it can result in
plethora of negative consequences.
Recent efforts to study the impact of social exclusion have resulted in a
scientific understanding of the impairments in functioning that social exclusion
and rejection produce, such as intrapersonal numbness (Baumeister and Tice,
2007), increases in aggressive behavior (Twenge, Baumeister, Tice & Stucke,
2001), decreases in pro-social behavior (Twenge, Ciarocco & Baumeister, 2001),
impaired logical reasoning (Baumeister, Twenge & Nuss, 2002), distortion in
time perception, lethargic passivity, and an avoidance of self-awareness (Twenge,
Catanese, & Baumeister, 2003), and increases in self-defeating behavior (Twenge,
Catanese & Baumeister, 2002). The following section will explore the research
on social exclusion in an effort to support this researcher’s hypothesis that social
exclusion is a likely contributor to the development of a desire to become HIV
positive.
Some of the most compelling research on social exclusion has been on the
emotional reaction of a rejected person. Although one may predict social
exclusion leads to negative emotion states, the research supporting this idea is
varied. Numerous studies on social exclusion suggested social exclusion and
social rejection led to distress, changes in mood, and anxiety (Baumiester and
Tice, 1990; Leary et al, 1998; Leary & Springer, 2000; Williams et al, 2000, in

35
Baumeister and Tice, 2007). Researchers have also found social exclusion
“elicits emotional distress and is usually accompanied by feelings of depression,
envy, loneliness and low self-esteem” (Briones, Tabbernero & Arenas, 2007, p.
659). However, Baumeister and Tice (2007) also noted not all research on
rejection supports the idea that rejection causes emotions. Instead they found “the
standard response to exclusion by laboratory participants seemed to be one of
numbness,” (Baumeister and Tice, 2007, p. 512). Thus, social exclusion appears
to have strong effects on emotion, however there does appear to be variance in the
individual emotional responses ranging from depression, and anger to a lack of
emotion and a sense of being numb. Furthermore, studies by DeWall and
Baumeister (2006) found that laboratory created experiences of social exclusion
resulted in human subjects losing their sensitivity to pain. This is compelling
given the research by Eisenberg, Lieberman, Williams MacDonald and Leary who
were cited in Maner (2007) that social exclusion precipitated a “psychological
state that resembles pain” (in Maner et al., 2007, p. 42). Thus, the research
supports the notions that social exclusion can create an array of physical and
psychological reactions including pain and numbness. If bug chasing is viewed as
a form of self injury, it is possible to see how it is used to combat the feelings of
pain, anxiety, depression or numbness that result from long term social exclusion.
In addition to pain and numbness, social exclusion has also been found to
impact cognition and self-regulation. A series of studies done by Baumeister,

36
Twenge and Nuss (2002) found individuals who experienced social exclusion had
a significant decrease in intelligent thought, which were measured by IQ and
reasoning tests. Furthermore, “exclusion mainly impaired logical reasoning,
extrapolation, and other mental operations that required moving from one set of
information to another” (Baumeister et al., 2007, p. 514). This information is
useful for understanding how social exclusion impacts an individual in decision
making, logical reasoning and new learning and behavior. In the context of bug
chasing, the social exclusion of gay men may produce similar difficulties resulting
in individuals making the decision to engage in bug chasing as a result of the
cognitive impairment.
Further research on the effects of social exclusion indicated social
exclusion can result in changes in interpersonal and intrapersonal functioning. In
their 2005 study, Baumeister, DeWall, Twenge and Ciarocco found being
excluded or rejected resulted in impaired self-regulation. They base their study
on research that found health, happiness, and well-being are strongly tied to
whether one is accepted or rejected. They state that people deprived of close
social ties suffer more negative physical and psychological consequences while
ostracized individuals exhibit a broad range of distress and pathology (Baumeister
et al., 2005). Furthermore, Baumeister and colleagues (2005) report on research
that suggests some interesting implications for bug chasing by explicating two
seemingly contradictory findings. On the one hand they find that rejected

37
individuals show more antisocial behavior and a decrease in willingness to engage
in altruistic behavior. On the other hand, it has also been found that socially
rejected individuals are more self-defeating than others by making more
unhealthy choices and procrastinating (Twenge et el., 2002 in Baumeister et al.,
2005). Baumeister and colleagues (2005) reconciled this contradiction by noting
“they both tend to involve self-regulation failures,” as self regulation is required
in helping people overcome selfish impulses, as well as is necessary for helping
people engage in “enlightened self-interest” (p. 590). Coupled with the
knowledge that “the most common form of self-defeating behavior involves
seeking short-term benefits that are accompanied by long term costs,”
(Baumeister et al., 2005,p. 590) one can see how the motivation for bug chasing
follows the proposed concept outlining how the benefits of bug chasing appear to
override the negative consequences of infection. Furthermore, given the data
regarding social exclusion and difficulty with self-regulation, self-defeating
behavior and impulsivity, it is possible bug chasing serves to mediate each of the
factors by those engaged in the process for the short term pursuit of pleasure over
the long term consequence of pain or illness
Research by Maner, DeWall, Baumeister, & Shaller (2007) looked at the
effect social exclusion had on motivation to forge new social relationships. Their
theory is based on a reconnection hypothesis. Reconnection hypothesis is based
on the concept that “when the satisfaction of an important drive is thwarted,

38
humans often find alternative means of satisfying that drive. The experience of
social exclusion may serve to signal that one’s need for social connection is not
being satisfied” (Maner et al., 2007, p. 43). Thus, for those MSM who have face
social exclusion as a result of their sexual identity, bug chasing may be a way to
connect with others who they feel will accept them. There are a number of
outliers and stipulations within this theory, including the acknowledgement that
socially excluded individuals are not likely going to try to seek connection with
perpetrators of exclusion, and would only “respond favorably towards others only
to the extent that those others are perceived as providing realistic sources of
renewed social connection” (Maner et al., 2007, p. 43). Furthermore, the theory
posits that there are individual differences in the tendency to view others as
possible safe sources of reconnection. As a result, “individuals who anticipate
negative social evaluation tend not to pursue novel social encounters for fear that
they will bring significant distress” (Maner et al., 2007 p. 43). Given this research
it is possible to see a link between the experience of social exclusion and the
desire to engage in a form of self injurious behavior, such as bug chasing.
Homosexuality and Discrimination: Stigma, Social Exclusion, and the
Development of Internalized Homophobia and Negative Self-Attitudes
“Heterosexuality is dominate, universal, institutionalized, privileged, and
pervades everyday practices and beliefs” (Carabine, as cited in Concannon, 2008,

39
p. 328). The literature on the impact of social exclusion is rife with studies that
describe how being a member of a marginalized group can often be linked to
negative outcomes. Gay men are likely to face discrimination and challenges on
a regular basis, as a result of homophobic attitudes, policies, and ideologies.
Most often, gay, lesbian, and bisexual individuals grow up in homes where
heterosexuality is assumed and expected. Individuals with same sex attraction
often have no role models within their family. And unlike other minority groups,
individuals with same sex attraction often face stigma, prejudice, and rejection
within their own families. Most early encounters young people have of romantic
partnerships are heterocentric and often breed a sense of heterosexuality as the
expected norm. Furthermore, research on belonging suggests, “to satisfy the need
to belong, the person must believe that the other cares about his or her welfare and
likes/loves him or her” (Baumeister & Leary, l995, p. 500). For those who grow
up gay and feel alone among a mostly heterosexual culture, one may develop a
sense of disconnection and a lack of belonging in early family relationships,
setting the stage for later difficulties with attachment and sense of connectedness.
In addition to the intrafamilial and the interpersonal heteronormative
expectations, social, political, and structural practices reinforce this heterocentric
and often homophobic stance. Meyer (2003) suggested minority stress develops in
GLBT individuals, as members of stigmatized groups. Often discrimination and
homophobia (hatred against people who are not heterosexual) exist together,

40
insidiously deepening the social exclusion gay people face on a regular basis.
“Individual discrimination refers to personal perceived experiences with
discrimination, whereas structural discrimination refers to a wide range of
‘institutional practices that work to the disadvantage of…minority groups even in
the absence of individual prejudice or discrimination,’” (Meyer, 2003, p. 690.)
Increasingly, North American society is recognizing the negative impact
discrimination has on disenfranchised groups. However, “unlike other forms of
oppression in our society, homophobia is more accepted. Preferential treatment
of heterosexuals is not only mandated by law, it is upheld by many governmental,
cultural, and religious institutions” (Perez, 2005, p. 25). As a result, members of
the gay community are likely to continuously experience a sense of oppression
and disenfranchment. Furthermore, “LGBT women and men have been
prohibited from basic civil and human rights with justifications ranging from
sinful behavior and mental illness, to political declarations about gay men being a
risk to national security” (Concannon, 2008, p. 327). It has been argued
discrimination against gay and lesbian people continues to remain socially
acceptable and an “institutionally sanctioned form of prejudice” (Huebner et al.,
2002, p. 328). Discrimination against gay men appears to be insidious, as it can
occur as overt discrimination, and less obviously, yet equally harmful, when it
occurs through subtle but important systemic and institutional discriminatory

41
policies. Concannon (2008) examined the impact of social policy on LGBT
issues and stated:
Failures on the past of successive UK and USA administrations to redress
many of the inequalities experienced by LGBT citizens, through policy
and the law, continues to demonstrate the heteronormative constructions
of rights which sees LGBT individuals marginalized and as second class
citizens (p. 327).
Thus, the implications of individual, social, and institutional discrimination are
pervasive and deeply embedded in policy and law.
Numerous studies suggest “varied manifestations on society’s intolerance
of gay and lesbian people have been empirically associated with both mental and
physical problems,” (Huebner et al. 2002, p. 328). Furthermore, researchers have
found that individuals who identity as gay, compared to heterosexuals, suffer
from more mental health problems including substance use disorders, affective
disorders, and suicide (Meyer, 2003). However, this does not mean that
homosexuals are inherently inclined to mental illness or disorder, but rather that
being a member of a stigmatized group produces emotional reactions and
behaviors that are a characteristic of mental illness. Furthermore:
the basic issue…is not whether some or many homosexuals can be
found to be neurotically disturbed. In a society like ours where
homosexuals are uniformly treated with disparagement or

42
contempt – to say nothing about outright hostility – it would be
surprising indeed if substantial numbers of them did not suffer
from an impaired self-image and some degree of unhappiness with
the stigmatized status…It is manifestly unwarranted and
inaccurate, however, to attribute such neuroticism, when it exists,
to intrinsic aspects of homosexuality itself (Marmor as cited in
Meyer, 2003, p. 674).
Halperin (2007) echoed this point strongly when he noted “what gay
people have in common, then, is not a psychological disorder but a social
disqualification” (p. 2). This distinction is valuable and often gets
misinterpreted in both benign and harmful theories. The larger message
needing to be heard is that gay men are often at risk of emotional issues,
not because of their homosexuality, but because of societal intolerance,
homophobia, and social exclusion.
An often complicated consequence of discrimination and social exclusion
is the development of internalized homophobia in non-heterosexual individuals.
This is often considered a reaction to forming a homosexual identity in the
context of discrimination and oppression towards homosexuals. Meyer and Dean
(1998) defined internalized homophobia as, “the gay person’s direction of
negative societal attitudes toward the self, leading to a devaluation of the self and

43
resultant internal conflicts and poor self-regard” (p. 161). Identity development is
complicated for individuals with same sex attraction given that:
Unlike other members of stigmatized groups, such as ethnic
minorities, gay and lesbian children do not grow up with parents
who share their stigmatized identity, and thus they have neither the
appropriate gay or lesbian role models nor parental buffers against
the antagonistic culture (Huebner et al., 2002, p. 330).
Bozett and Sussman (1990) defined internalized homophobia or internalized
homonegativity “as the taking in or internalization of society’s negative attitudes
and assumptions about same-gender sexual orientation by gay and bisexual men”
(as cited in Dew and Chaney, 2005, p.261). The effects of this personal and
structural discrimination can become included in one’s sense of identity and selfconcept,
such that internalized homophobia can impact numerous areas of
development such as identity, formation, self-esteem, and psychological
coherence (Dew and Chaney, 2005). Therefore, a non-heterosexual individual
who internalizes both explicit and implicit homophobia can experience a sense of
diminished self worth and value.
Meyer (1995) noted gay people are subject to stigma, prejudice, and fear
as a result of their minority status, and are impacted by “minority stress,” a term
first suggested by Virginia Brooks in l981. The term minority stress is defined as
“being related to the juxtaposition of minority and dominant values and the

44
resultant conflict with the social environment experienced by minority groups”
(Meyer, 2005, p. 39). To support this thought Meyer wrote, “this concept is based
on the premise that gay people, like members of other minority groups, are
subjected to chronic stress related to their stigmatization” (Meyer, 2005, p. 38).
Meyer does note there are numerous ways an individual can react to
stigmatization, with both adaptive and maladaptive responses which sometimes
present as mental health symptoms. Thus, minority stress develops as a minority
person’s experience of themselves differs from the social and structural
expectations of the heteronormative dominant culture.
The impact of internalized homophobia can be diffuse, and often out of
the conscious awareness of gay men. Yet recent studies show that the effects of
internalized homophobia can be dangerous and related to higher rates of chemical
dependency, suicide, and social isolation among men who have sex with men
(Dew and Chaney, 2005, p.262). Researchers have also linked internalized
homophobia to “low self-esteem and depression, maladaptive coping styles and
low social support,” (Huebner et al., 2002, p. 328). In their own study, Dew and
Chaney (2005) found internalized homophobia had a negative impact on a gay
and bisexual male’s overall mental health and wellness. This process can be
explained through a developmental model that suggests individuals self identify
as homosexual “before any public disclosure of their homosexuality, but as selflabeling
begins, individuals also begin to apply negative attitudes to themselves

45
and, and the psychologically-injurious effects of societal homophobia take effect”
(Meyer, 2005, p. 40). As a result an individual may develop a self-concept of
deviancy, due to not fitting within a heteronormative framework. Meyer (1995)
found “internalized homophobia, expectations of rejection and discrimination, and
actual events of discrimination and violence – considered independently and as a
group – predict psychological stress in gay men,” (p. 51). Further evidence
suggests a “relationship between internalized homophobia and various forms of
self-harm, including eating disorders, and HIV-risk taking behaviors” (Meyer,
2003, p. 682).
In their article investigating risky sexual behavior in gay and bisexual
men, Kashubeck-West and Szymanski (2008) described a number of factors that
contribute to high-risk sexual contact among men who have sex with men. One
of the factors they referred to is the research linking risky sexual behavior and
internalized heterosexism, which is the internalization of negative attitudes and
assumptions about homosexuality. They point out:
Men who score high in IH [Internalized Homophobia] are thought
to (a) be less connected to the gay community and therefore have
less access to HIV/AIDS information and resources; (b) be
vulnerable to lower self-esteem, which in turn may reduce one’s
desire to protect oneself from HIV; (c) be more prone to shame and
therefore increased self-destructiveness; (d) be likely to have more

46
difficulty in establishing same-sex intimate relationships; and (e)
have a greater need for escapism (Kashubeck-West and
Szymanski, 2008, p. 596).
In addition to internalized heterosexism, Kashubeck-West and Szymanski
described sensation seeking as another factor linked to risky sexual behavior.
They described sensation seeking as “the tendency of a person to seek optimum
arousal and engage in risky behaviors” (p. 597). Furthermore, they assessed the
role of substance use as a mediating factor between risky sexual behavior and
internalized heterosexism. Kashubeck-West and Szymanski found:
As IH [Internalized Homophobia] increased the expectation that
substance use would enhance sexual experiences rose, which in
turn was associated with greater RSB [unprotected anal
intercourse]…Greater sensation seeking was associated with
stronger expectancies that drug and/or alcohol use would enhance
sexual activity, which in turn was associated with greater
unprotected anal intercourse (p. 607).
It is possible to extrapolate from this research the notion that internalized
heterosexism/homophobia is a factor contributing to risky sexual behavior and
sensation seeking through the use of self-destructive means.
Research has also been done on stress ameliorating factors that help an
individual who is a member of a marginalized group. Meyer (2003) noted that

47
although minority status can be associated with stress, group solidarity and
cohesiveness often serves as a protective factor. This is evidenced by
psychological researchers who have “demonstrated the positive impact of
affiliation with other similarly stigmatized persons on self-esteem” (Meyer, 2003,
p. 682). However, for some individuals in the gay community who are lonely or
surrounded by peers who are HIV positive, becoming HIV positive may serve as a
perceived remedy and way to find a sense of camaraderie. Baumeister and Leary
reported on Barden, Garber, Leiman, Ford and Masters in 1985 that found
“anxiety ensues if people are excluded from social groups, but experiences of
social inclusion appear to counteract the effects of exclusion” (Baumeister &
Leary, l995, p. 506). It is therefore possible to view the motivation for bug
chasing as a desire to ameliorate the anxiety that results from living in a
homophobic society and by becoming HIV positive one can find a sense of
belonging in connection with other HIV positive and marginalized people. It is a
way to both find a place of belonging and to challenge the greater
heteronormative societal structure. Meyer (2003) also described a study that
found lesbian, gay, and bisexual adolescents fared better on mental health
outcomes related to anti-gay abuse with family support and self-acceptance. This
further supports the hypothesis that bug chasing individuals seek out HIV because
of a lack of self-acceptance and social supports.

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One question that has often been asked regarding bug chasing is how the
behavior is related to suicide or a death wish. Research on suicide offers an
explanation that may help explain why a gay man may wish to become infected
with a virus such as HIV that can be deadly. Baumeister (l990) suggested that
suicide is an attempt to escape from the self, following the Escape theory of
suicide. Escape theory is composed of six main steps:
First a severe experience that current outcomes (or circumstances)
fall far below standard is produced either by unrealistically high
expectations or by recent problems or setbacks, or both. Second,
internal attributions are made, so that these disappointing outcomes
are blamed on the self and create negative implications about the
self. Third, an aversive state of high self-awareness comes from
comparing the self with relevant standards (in connection with
self-blame for recent disappointments). This individual is thus
acutely aware of self as inadequate, incompetent, unattractive, or
guilty.
Fourth, negative affect arises from the unfavorable
comparison of self with standards. Fifth, the person responds to
this unhappy state by trying to escape from meaningful thought
into a relatively numb state of cognitive deconstruction. This
escape is not fully successful, however, and so the individual
desires increasingly strong means of terminating aversive thoughts

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and feelings. Sixth, the consequences of that deconstructed mental
state include a reduction of inhibitions, which may contribute to an
increased willingness to attempt suicide. Suicide thus emerges as
in escalation of the person’s wish to escape from meaningful
awareness of current life problems and their implications about the
self (Baumeister, 1990, p. 91).
Following this theory, it is possible to see the connection between internalized
homophobia and the desire to escape a sense of distressing self-awareness through
indirect suicidal motivation through which bug chasing becomes the method. The
first step of escape theory is an experience what one feels when they fall below
standards. As a gay individual comes to an awareness of their homosexual urges
and identity, they have to face the realization of the existence of homophobia, and
the notion that as a gay individual they do not fit within the heteronormative
culture. Following the second and third steps of the theory, gay individuals make
internal attributions about their sexual identity and a high self-awareness of
difference develops, resulting in self-blame, feelings of inadequacy, and pain.
The fourth step occurs when a person experiences negative affect based on the
sense of self not meeting expectation or standards, and for a gay individual the
development of feelings of distress, pain, sadness, and anger towards the self (i.e.
internalized homophobia) for not meeting expected standards. As the person tries
to escape from the affect, the theory posits that they move towards a state of

50
numbness and cognitive deconstruction, through which a reduction of inhibitions
occurs. For a gay individual who goes through this process, bug chasing may be
an unconscious attempt to numb out the distressing affect, and a way to escape a
sense of self hate. Thus, it is possible to see how a person engaging in bug
chasing behavior develops an attraction to and a desire for a deadly illness. The
question remains though: why is it only a small percentage of gay men actually
engage in bug chasing behavior if they are all victims of stigmatization and social
exclusion?
It appears necessary to investigate the conscious motivational factors
underlying bug chasing behavior to better understand what, if anything should be
done both in the public health domain and in the psychotherapy field regarding
individuals seeking HIV. LeBlanc (2007) sought to understand these issues in a
study done investigating the psychological and sociological contributions bug
chasers name in explaining their behavior. He described a need for research
investigating the sociological and social-psychological perspectives of the bug
chaser, without a research imposed theory of deviance. Furthermore, framing
such behavior as deviant without a research-based assessment of bug chasing
behavior from a phenomenological perspective can have the effect of
pathologizing an individual without a direct assessment of the purpose or meaning
of the behavior, and is epistemologically unsound.

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First, although a number of researchers suggest bug chasers no longer
view HIV as a deadly illness, but rather a manageable illness, the question
remains, what drives a person to seek out any sort of illness, either manageable or
deadly? Can individual factors alone account for this behavior? Perhaps by
focusing on individual pathology one can absolve themselves and their culture
from blame for contributing to another person’s desire to become ill and possibly
die. By focusing on individual pathology one does not have to address the social
and contextual contributions of this behavior and therefore avoid making difficult
and often controversial changes for the health of all members of society.
CHAPTER 3: METHODLOGY
Methodology for this Study:
My research is based on two dimensions. First, a literature review was
conducted to assess the proposed explanations of the motivation to engage in bug
chasing behavior. The literature in this area is based largely on theory and rarely
on direct examination of the phenomenology of the individuals engaged in bug
chasing behavior. This research utilized data that was a direct assessment of how
individuals engaged in bug chasing behavior understand and explain their
experience and motivation. Additionally, literature regarding internalized

52
homophobia and social exclusion were also reviewed. What emerged from this
review is the likely connection between bug chasing behavior and social
exclusion.
My relied on archival data that was collected by Bruce LeBlanc (2007). In
his exploratory study LeBlanc chose to “suspend” dominant theoretical and
methodological paradigms and “not to ground itself in the existing foundational
theoretical perspectives” which framed bug chasing as deviant (p.13). He
attempted to examine the experience of bug chasers, suspending the concept of
bug chasing as inherently deviant, in an attempt to explore the behavior absent
from a pre-constructed theoretical framework. This research utilized Leblanc’s
data, using a modified interpretive phenomenological analysis (IPA) approach.
Interpretive phenomenological analysis is considered an appropriate and
valuable method for investigating meaning making and sense making of
participants. Smith and Osborne (2008) noted IPA is “a suitable approach when
one is trying to find out how individuals are perceiving the particular situations
they are facing, how they are making sense of their personal and social world” (p.
55). IPA does not attempt to test a specific hypothesis, but rather qualitatively
explore the areas being researched. This approach was suited for this study as this
researcher was not interested in quantitatively qualifying bug-chasing behavior,
but rather to understand how an individual engaging in bug chasing makes sense
of their own experiences and motivations. IPA also recognizes that a researcher is

53
unable to get direct access into a subject’s inner world, and therefore, the analysis
done by the researcher is always an interpretation of a participant’s experience
(Willig, 2008). As a result, it is necessary to note that through IPA the
researcher’s goal is to understand the participants’ subjective experience, and can
provide an objective understanding of the purpose and phenomenology of the
individual engaged in bug chasing behavior.
The reason the style of data analysis was described as a modified IPA is
due to the secondary nature of the data analyzed in this research. This researcher
chose not to collect original data for a number of reasons including difficulty
gaining access to available and willing participants, as well as time constraints.
Archival research data was used to gain access into a community that is often
defensive towards outsiders due to fear of condemnation and insensitivity.
Therefore, this researcher chose to use the archival data previously collected,
rather than attempt to infiltrate and gain acceptance into a bug chasing community
in the attempt to collect these data. This researcher also described her approach as
a modified IPA given that she was not a part of developing the survey instruments
utilized, and is doing a secondary review of the data. Modifying IPA is permitted
and was appropriately used, as Smith and Osborn (2008) noted, “you may find
yourself adapting the method to your own particular way of working and the
particular topic you are investigating” (p. 55). The data used in this research had
been previously collected and analyzed by another researcher. However, this

54
researcher chose to use IPA versus the original analysis technique used by Dr.
LeBlanc.
Methodology of Archival Data:
Using a modified IPA approach, this researcher analyzed the themes
produced by responses given to Bruce LeBlanc’s survey of individuals selfidentified
as bug chasers. His survey was a qualitative internet study where data
was collected for six months. All methods are fully described in LeBlanc’s
(2007) article, but will be summarized here for clarity. He entered “high risk”
chat rooms soliciting subjects at varying days and times. He used “Researcher” as
a screen name so subjects would be aware of his intentions upfront, focusing on
soliciting subjects for his research study. Individuals who agreed to participate
first viewed an informed consent before being given access to the survey
questions. LeBlanc chose only to include individuals who self identified as bug
chasers on the survey, not just due to their presence in the chat room. Once they
clicked on the link to the study, participants were given background information
and asked to sign an “Informed Consent.” Once consent was given, participants
were allowed access to the survey. Participants were not required to answer all
questions, and the researcher was unable to link a participant’s response to each of
the questions, impacting the researchers ability to assess for continuity in
responses. Both demographic and qualitative information were collected.

55
LeBlanc collected qualitative data from participants utilizing an online
survey format. Participants were given the option of choosing to either answer
each qualitative question, or to not respond. Thus, not all questions had a uniform
number of responses. Additionally, the survey tool did not allow this researcher
the opportunity to track each participant’s response to each of the questions. The
responses to the following open-ended questions were analyzed in this research:
(1) Why are you seeking to become infected with HIV? (2) What are the
psychological factors [i.e. internal thought processes] that you believe are
contributing to your seeking infection with HIV? (3) What are the social factors
[i.e. interactions with others] that you believe are contributing to your seeking to
become infected with HIV? LeBlanc’s (2007) original research included
responses to other questions, however, this researcher chose to exclude responses
to those questions because they did not address the phenomenology of the
behavior, but rather were explicit and pragmatic questions regarding how such
issues as the sexual practices were used to gain infection, number of sexual
partners, and how participants met individuals willing to infect them.

56
CHAPTER 4: RESULTS
Archival Demographic Information:
This research relied on archival data, and no further participation was
required. The archival data being used in this research did not require participants
to complete each question, and therefore not all questions have the same number
of answers. Eighty participants participated in this research. Regarding the racial
demographics of the participants, seventy-four were Caucasian, two were
Hispanic, one identified as black, one as asian, one was listed as other, and one
did not specify. Fifty-eight participants identified as single, one was married, six

57
were in short-term relationships (under two years), and fifteen were in long-term
relationships (over two years in length). In terms of residence, 43% came from
cities with a population above one million people, 12.7% from cities of 500,000-
999,999 people, 11.4% from cities of 100,000 to 249,999 people, 9% from cities
250,000-499,999, 6.3% from cities of 50,000 to 99,999, 5.1% from cities of
25,000 to 49,999, 5.1% from cities with populations of 10,000 to 24,999, and
7.6% came from cities with populations of less than 10,000 people. In terms of
education, all but two participants had a high school education while 69 attended
college, 51 of these completing a bachelor’s degree or higher, with 10 participants
earning a master’s degree, and 4 receiving doctoral degrees. Additional
demographic information can be found in LeBlanc (2007).
Question 1: Why are you seeking out infection?
There were 80 responses to the question “Why are you seeking to become
infected with HIV?” Four of the responses were not analyzed because
respondents did not respond with interpretable words or phrases (example:
“vcbdbadfgbadfadfhafhadfhadfhdfdfas”). Four participants noted they are
currently HIV positive, while one noted he is actively avoiding it. Another
reported he is not seeking out HIV or engaging in bug chasing but “just likes to
hear about it” as a sexual turn on. Although the website and survey were

58
specifically targeting people engaged in bug chasing, it is clear not all
participants’ sole motivation was seeking out people to give them HIV.
Sexual enhancement was a primary theme in the responses to these
questions. Fourteen responses centered on a preference for bareback sex, and two
of those specifically noted a dislike of condoms because they create a barrier.
Sexual freedom was also a goal for one participant who believed obtaining HIV
would allow for sexual freedom. One individual stated he wanted “as much sex
possible” and that served as an explanation for his bug chasing behavior. Bug
chasing was also mentioned as a sexual turn-on in thirteen responses, and ten
others noted finding the possible danger and risk involved with bug chasing
erotically stimulating as their reason for bug chasing. Three people mentioned
finding the idea of being submissive and controlled arousing and a component
motivating bug chasing. Two individuals noted their bug chasing was spurned by
an attraction to “dirty” or “kinky” sex, and another two participants reported a
similar attraction to “risky sex.” This is different than the participants who did
note finding bug chasing a turn-on but did not report specifically being attracted
to risky sex.
The next common theme that emerged was seeing HIV as inevitable and
no longer wanting to have to worry about seroconversion. Nine respondents noted
their motivation for bug chasing is because they believe infection is inevitable
(example: “know that it will happen one day anyway, so am taking action so that I

59
get infected how I want to be”). Similarly, seven individuals noted their
motivation was to no longer have to worry about when/if they would be infected
(examples: “So I can stop worrying about it,” and “I wanted to stop worrying
about it…If I got it over with, no more worry about the risk, just the joy of
fucking”). Interestingly nine respondents noted being indifferent to infection and
did not describe obtaining HIV infection as the purpose of their behavior. This is
exemplified by the individual who stated “not actively seeking infection but do
have unprotected sex with men who may be HIV positive”. Four individuals
noted they did not know why they were seeking to become HIV positive.
Interpersonal factors were the next most commonly cited motivators for
bug chasing. Nine participants described interpersonal reasons for bug chasing.
These varied from searching for a sense of belonging (wanting to “join the club”),
loneliness, and a belief that it is the only way to find a willing sexual partner.
Two people specifically mentioned finding the rush it gave to their sexual partners
as a motivator, while one participant reported his boyfriend is HIV positive and
will no longer have sexual contact with him because he does not have HIV. One
participant specifically noted being tired of taking precautions with his long-term
partner. Three participants also noted they are motivated to bug chase because of
a desire to give it or “spread” it to others. Three men had themes of death in their
response. Of these, one noted he is turned on by the idea of turning his life over
to someone else, whereas the other two mentioned bug chasing as a way of

60
seeking a way to death, meaning suicide. Another participant specifically cited
his depression as a contributing motivator. Two individuals reported bug chasing
as “compulsion” or “obsession.” Other responses that appeared idiosyncratic
included: a desire to be “impregnated” by the virus, “because I want it.”
Question 2: What are the psychological factors (i.e. internal thought
processes) that you believe are contributing to your seeking infection with
HIV?
Sixty-seven participants chose to answer this question. Three responses
were unusable because they did not contain interpretable content (e.g.
“vcbdbadfg”). Therefore, sixty-four responses were interpreted and analyzed.
Some responses contained more than one category or theme and each of the
segments was interpreted. The most commonly described psychological factor
cited was the notion of the thrill of danger or risk (10 responses). Five
participants mentioned bug chasing as “hot” but did not give a reason such as the
risk or thrill. Interestingly, an equal number of participants reported they were
“unsure” of the psychological factors underlying the motivation for bug chasing
behavior (10). Another three participants responded with “none.” Six responses
specifically mentioned interpersonal motivations, including three responses that
noted the pleasure they believe it gave their sexual partner. One man described
how much pleasure it gave his partner stating “When I was done getting filled

61
with my first poz load I looked into the eyes of the guy as he was cumming and I
never saw anyone seem to enjoy what he was doing like he was. That was a turn
on.” Of the six interpersonal responses, two cited “loneliness” specifically, while
another two participants noted it was the only way to get people to love them or
be interested in having sexual contact with them. Four responses contained
“don’t care” although it is not clear how this should be interpreted.
The next common set of responses pertained to worry and seeing HIV as
inevitable. Four participants noted eventuality as a motivator, whereas five
persons described no longer wanting to have to worry about contracting the virus
as a factor. Of those who described wanting to stop worrying, one specifically
noted no longer wanting to fear sex as dangerous, and two mentioned wanting to
have control over the conversion process. Another two respondents mentioned
seeing bug chasing as a way to experience sexual freedom and no longer having
to fear sexual contact. Improving one’s sex life was another common theme
mentioned. Two participants specifically noted they dislike condoms, this being a
psychological factor motivating bug chasing (“Once you bb a few times and feel
the increased sensitivity, it’s too hard to go back to using rubbers” and “Sex with
condoms is lousy”).
Another cluster of themes that emerged regarding psychological factors
was mental health and self-esteem issues. One participant noted “depression”
while another reported being “bipolar and probably emotionally unstable.” Two

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people mentioned bug chasing being an “obsession” or obsessive thought. One
person noted being a “sex addict” as the psychological factor. Low self-esteem
and self-destruction were also mentioned by two individuals (“I want to destroy
myself. I am worthless and the world is shit”). One participant stated he believes
he is a “perverted freak.” Two participants stated advances in drugs or a
decreased impact if infected as the psychological factors contributing to bug
chasing. Idiosyncratic responses that were echoed by other participants included:
“internal thought process,” Adrenaline rush of will I get it or am I immune,” “I
realize a lot of people think this is wrong or sick…I can’t explain why I want it so
bad,” and “because it is my life and I want to be HIV positive,” and “hot cum in
me.”
Question 3: What are the social factors (i.e. interactions with others) that
you believe are contributing to your seeking to become infected with HIV?
Sixty-one participants responded to this question. Three responses were
not analyzed because they did not contain interpretable material (e.g. “f” or “I’d
say the same”). The commonly described response to this question had to do with
social connection (mentioned in 16 responses). Examples included responses that
described a sense of loneliness (2 responses), seeking to become part of a
community or “brotherhood” (3 responses), and feeling “left out” (1), and a desire
to feel accepted (1). A subset of socially oriented responses included two people

63
who reported a desire to bug chase so they in turn could give it to others. Another
participant noted being encouraged and supported by others on the Internet to
engage in bug chasing. The second most common set of responses were those
that gave no reason other than “none” (8 responses) or “don’t know” (another 8
responses). This pattern of unexplained reasoning was echoed in the previous
questions.
Another theme that emerged from the responses was regarding the
internet. Four participants specifically mentioned the internet as a contributing
feature on their answers. This supports the research that the internet serves a
function in bug chasing behavior: a place where bug chasers connect. Sexual
enhancement was another theme that emerged. Four responses indicated a dislike
of condoms or a preference for bareback sex. Another three participants reported
the social motivations for bug chasing included a “love of sex” and a desire to be
known as “total slut.” Another participant noted a desire to be used sexually as a
contributing factor. Another four participants included finding HIV positive men
“hot” and bug chasing as a way to get “with hot men.” In regard to a desire for
the transgressive, three responses contained themes of an attraction to the “taboo”
or “dirty/shameful” sex. One participant explicitly stated “Perhaps being gay is
so mainstream now that the ‘danger’ associate with gay sex is gone. Maybe I
identified with the closeted lifestyle to the point that now, there is no more closet.
Maybe having HIV helps get regain the ‘taboo’ I was comfortable with.” Two

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people noted a desire to no longer have to worry about contracting the virus and
just getting it over with, and another participant noted the contraction of HIV as
inevitable. One participant described condom fatigue and being tired of taking
precautions. Other responses that were not described by other participants
included: “like it,” “family relationships and religion,” and “depression.”
CHAPTER 5: DISCUSSION
Interpretation of the Results:
Looking at the responses of individuals engaged in bug chasing behavior it
becomes clear there is no one reason individuals seek out HIV infection. Like
most human behavior there appears to be a complex interplay of factors that
contribute to a desire to become HIV positive. The themes that emerged from
questioning these individuals engaged in bug chasing regarding the purpose and

65
motivation of their behavior challenges many of the theories suggested by
previous researchers.
This research supports Moskowitz and Roloff’s (2007a) study which
found bug chasers often fit in two distinct categories, the ardent and the apathetic.
This researcher also noticed similar patterns within this sample. In each question
analyzed by this researcher some men responded as actively seeking out the virus
as a primary motivator, while almost an equal number reported being ambivalent
or apathetic about infection. The apathetic chasers in this research appeared
ambivalent about seroconversion and did not appear to strongly identify with a
bug chaser identity. The ardent chasers were clear in their commitment to
infection and seroconversion and were strongly identified with the bug chasing
identity. Based on the responses provided in this research it appears likely that
differences in identity and behavior between apathetic and ardent chasers warrants
further investigation to understand the similarities and differences in how these
belief systems and behavioral patterns differ among the two groups.
The four overlapping lines of explanation proposed by Gauthier and
Forsythe (1999) regarding bug chasing behavior were supported in this research;
however, these four themes do not fully encompass the array of reasoning for
engaging in bug chasing behavior. Their model included the following themes:
risk taking as eroticism, fear and relief, loneliness and group solidarity, and
political action. Each of these themes were represented in this sample. However,

66
this research had as many participants who were unable to explain the motivation
for their behavior as those that fit into the themes presented by Gauthier and
Forsythe. Perhaps Moskowitz and Roloff’s research in differing types of bug
chasers can be useful to understanding how so many participants do not have
explicit motivations for their desire to seek out HIV.
One theme commonly sited by the participants in this study that has not
been discussed at length by researchers in this area is a preference for bareback
sex. Many participants noted a desire to engage in bug chasing behavior because
they find it erotic, or “hot.” This echoes findings by Kashubeck-West and
Syzmanski (2008) who linked high risk sexual behavior with internalized
heterosexism. Furthermore, their study also linked sensation seeking with high
risk sexual behavior, suggesting a connection between internalized
heterosexism/homophobia and risky sexual behavior. Thus, a connection between
high risk sexual behavior, IH, and bug chasing appears to exist. However, further
research linking these behaviors is necessary to strengthen this assertion.
Many participants described the possibility of obtaining HIV and the risk
involved as the erotic factor. However, others did not use the possible risk
involved as the prime motivation and instead a preference for unprotected sex
because a belief that it is a more gratifying sensual experience. Interestingly, not
all self-identified bug chasers are primarily motivated by a desire to seroconvert,
and instead may be better understood with a different term. Two themes emerge

67
following this logic. Some participants noted an improved physical sensation in
condomless sex where other participants reported an improved sense of intimacy
with literally “no barriers.” These ideas were not idiosyncratic and appeared in a
number of responses and should be taken seriously. Although condomless sex
does increase possible risk, it appears likely that for some the risk is not strong
enough of a deterrent for the benefits they perceive in being able to have
unprotected sex. It appears it may be beneficial for further research on this topic
to assess whether those “bug chasers” who are not intentionally seeking HIV, but
instead prefer not to use a condom, are best understood as bug chasers or possibly
understood through a different term than bug chaser. It is necessary to note that
those men who chose to forgo condoms for sexual pleasure understood the risk
involved in that decision and are engaged in passive or ambivalent bug chasing.
It is likely that in many cases the explicit preference for not using condoms is
strong, however further investigation should be done to assess what unconscious
factors stimulate a desire to engage in high risk and possibly self-harming sexual
behavior.
About ten percent of the responses echoed Gauthier and Forsythe’s (1998)
fear and relief themes. These responses tended to include a sense of HIV
infection as inevitable. Similarly seven of 76 responses to the question regarding
“why” had to do with no longer wanting to worry about infection. Given these
responses it appears for many, the feelings associated with not knowing when one

68
will be infected are so anxiety provoking that the benefit of knowing when one
will be infected is worth the effects of HIV infection. It is likely a desire to
reclaim control over what is perceived as inevitable infection is felt as a tool for
relieving anxiety and thus a responsible for some individual’s desire to
seroconvert.
Interpersonal factors were commonly described as reasons for a desire to
seroconvert by participants in this study. For many bug chasing was perceived as
a way to find a community or sense of belonging. Given the research on social
exclusion and especially the l985 study by Barden et al. (as cited in Baumesiter
and Leary, l995) that found social inclusion ameliorates the effects of social
exclusion, it is possible to see how bug chasing serves to provide a community
and place of belonging for those individuals who have been ridiculed as a result of
their sexual behavior. Interestingly, some participants noted the rush or pleasure
it gave their sexual partners. Although many individuals engage in bug chasing to
improve their own sexual pleasure, it appears that some men are interested in the
process because of the sexual pleasure it appears to give their sexual partners.
Others appear to use bug chasing as a way to make themselves attractive to people
they believe would not otherwise be interested in them sexually. Numerous
participants, indicating a connection between social exclusion and the desire to
engage in bug chasing behavior, also mentioned social disconnection.

69
It is important that the diversity of responses and themes described by the
participants in this research not get lost in other conclusions that may be made
about the nature of bug chasers as a group. It is clear from this research people
engaged in bug chasing have a range of underlying motivations and reasons for
their behavior. It appears the reasons and motivations for bug chasing are diverse
and no one theory can account for why an individual may desire to assume the
identity and behavior of a bug chaser. Although it is useful to understand the
common factors shared by those engaged in any subset of behaviors, it negatively
impacts treatment if the phenomenology of an individual is not assessed and
addressed by the mental health treatment provider. The need to understand the
sociology and psychology of bug chasers as a group is important for developing
theories to conceptualize the behavior and develop prevention strategies.
However, mental health treatment providers should explore the individual’s
phenomenological motivation for bug chasing to best address the explicit and tacit
feelings underlying the desire to seroconvert. In this research I attempted to
understand the common themes individuals engaged in bug chasing believe
motivate their desire to become HIV positive. What became clear is the idea that
although common themes exist, there appears to be an idiosyncratic element to
each response. Rich and important information exists in the idiosyncratic way a
person develops a desire to engage in these types of self-harming behaviors and
treatment providers need to address these phenomenological elements. It is

70
especially important psychotherapists, understanding the individual from a
biological, sociological, and psychological perspective will likely facilitate a more
deeply integrated therapeutic change.
Underlying Psychological Factors: The Role of the Unconscious
One factor that was not measured in this study that may be helpful in
understanding the psychology of bug chasers is the concept of conscious versus
unconscious processes and how they influence behavior. In this research many
participants described explicit reasons for intentionally seeking out HIV infection.
However an almost equal number were unable to explicitly articulate a reason for
their desire to seroconvert. These participants responded that they were unsure or
did not know why they were motivated to bug chasing or were ambivalent about
becoming infected with HIV. This is where the integration of research on
minority stress, internalized homophobia, and social exclusion may be helpful in
conceptualizing the desire to engage in bug chasing behavior.
It is important to integrate bug chasing behavior and identity with the
research on internalized homophobia and minority stress. The desire to
seroconvert appears to be influenced by many factors. Further research should
investigate the impact of a possible predisposition towards anxiety, depression,
and an array of other psychological issues that contribute to a desire to self-harm
in this population. However, the impact of social and structural homophobia and

71
discrimination is one factor that has been largely ignored by previous researchers.
By viewing bug chasing as a reaction to being a member of a stigmatized and
marginalized population the individual is no longer blamed for their experience
and instead bug chasing can be viewed as their maladaptive attempt at coping
with psychological and emotional distress. My argument is that individuals are
impacted by discrimination and social exclusion on both conscious and
unconscious levels. I assert that many individual engaged in bug chasing
behavior do so as a reaction to this internal conflict between a same sex attraction
and an internalization of homophobic messages and social exclusion. In many
ways, bug chasers are held in contempt for their sexual identity and then further
pathologized for their attempts at managing their emotions through bug chasing
behavior. It is important that researchers and treatment providers integrate the
ideas presented in this research regarding internalized homophobia, minority
stress, and social exclusion when trying to understand bug chasing behavior. This
is not to say that social exclusion and internalized homophobia are evident in all
bug chasers. However, to ignore or omit these factors and instead “blame the
victim” does not help address the underlying social and systemic issues
contributing to the development of such maladaptive behavior.
Clearly more research needs to be done to strengthen the connection
between internalized homophobia as a result of social exclusion. However, in
taking an approach that incorporates not only individual factors, but also the

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social, cultural and political factors involved a more honest and realistic
understanding can be made regarding how to treat and prevent self-harming
behaviors in MSM. By viewing reframing bug chasing as motivated by
individual and social factors the responsibility for health falls on individuals and
socio-political systems. For those individuals working for treatment and
prevention of bug chasing behavior, it appears imperative that advocacy against
homophobia be a primary focus in both individuals and systems.
Bug Chasing as a Form of Self-Injury:
In many ways bug chasing behavior can be viewed as another form of self
injurious behavior. The purpose of self-injury is to provide relief from unpleasant
emotions or to create a sensation for those who feel numb. Favazza, (in Strong,
l998) a scholar of self-injury described how “it provides a temporary relief from a
host of painful symptoms of anxiety, depersonalization and desperation…it also
touches upon the very profound human experiences of salvation, healing, and
orderliness” (p.34). Given the research on social exclusion and the effect it has on
emotion it is possible to see bug chasing as the self-injuring behavior that is used
to modulate affect or induce a strong physical or emotional sensation that removes
the haze of numbness that often develops in studies of social exclusion. Bug
chasing can be thought of as a way to manage distressing affect, and sex is clearly
a way to induce an elevated mood state. Bug chasing is different than other forms

73
of self-injury in many ways, including timing. In bug chasing physical pain does
not appear to be a prime motivator. However clearly there is an element of harm
inherent to HIV infection. Thus, bug chasing appears to be, on some level, a form
of long-term self injurious behavior. Interestingly, bug chasers use sex as the tool
for self-harm. Following the theme of social exclusion as contributor to
internalized homophobia and factor in the desire to seroconvert, it is noteworthy
that sex is both the reason they are socially excluded and the tool chosen for selfharm.
It is appears likely that this is a reclaiming of one’s “dark side”, known as
the Jungian shadow. This is similar to the way many words have been reclaimed
by marginalized groups in an attempt to remove the pain and hate they represent
(Brontesma, 2004). Bug chasing then becomes a way to reclaim one’s sense of
value for the exact activity that has caused pain and self-criticism. Thus, bug
chasing serves as a liberation from societal expectations and a detaching oneself
from norms through a pleasurable act that is also self-harming.
Like other forms of self-injury, when people hear about bug chasing they
often have reactions of shock and revulsion. It is this researcher’s opinion that
like other forms of self-injury, the person engaging in the behavior is often
blamed for their illness and ostracized because of the maladaptive coping
behavior they developed. It is important that treatment providers do not further
stigmatize people engaged in bug chasing when they seek out mental health
services, either for issues related to bug chasing or those that are unrelated.

74
This research is suggesting that social exclusion predisposes and
individuals to internalized homophobia and self-hatred. However, there are
clearly biological, sociological, and psychological factors that contribute to the
development of bug chasing behavior and identity. It is likely an interplay
between these factors contributes to a desire to seroconvert, and by ignoring either
the biological, psychological or social factors one cannot fully understand the
development and proliferation of bug chasing behavior. Further research should
be done to investigate the connection between bug chasing and predisposition to
psychiatric disorders such as anxiety, or depression, as well as factors such as
impulsivity. Previous researchers have focused on the individual psychological
factors contributing to bug chasing, without incorporating the other domains. The
previous researchers cited in the literature review focused on the individual
cognitive distortions that likely motivate bug chasing and have ignored the other
psychological, biological, and sociological factors that contribute to a desire to
engage in bug chasing behavior. Further research in this area will be necessary to
better understand who is at risk for developing maladaptive ways of coping with
the discrimination and social exclusion that MSM face. It is important that further
research regarding bug chasing behavior looks at the social, cultural, and systemic
factors as well as the individual bio-psycho-social factors that contribute to a
desire to engage in bug chasing behavior.

75
By viewing bug chasing as a form of self-harm, as a reaction to social
exclusion, and a predisposition to maladaptive coping strategies, one no longer
places the sole responsibility of change on the victim. Instead, the social and
structural forces that contribute to feelings of minority stress and self-criticism
need also to be held responsible for the role they play in harming those
individuals who diverge from heterosexual normativity. This is where the
research on social exclusion and internalized homophobia is important.
Internalized homophobia develops as a reaction to lacking sufficient resources to
psychologically confront the barrage of homophobic and discriminatory situations
a gay person encounters. As a reaction, a sense of disconnection and social
exclusion develops. In turn this contributes to a sense of self-hatred and shame.
Furthermore it is likely internalized homophobia becomes exacerbated by social
exclusion over time, which may intensify the negative impacts. As a result, it is
possible to see how emotional numbness develops, as well as difficulty in making
intelligent decisions, and a preference for short-term benefits rather than longterm
goals. These factors can all be seen in bug chasing behavior. The short-term
benefit of having unprotected sex is less important than the long-term
consequence of HIV infection. Increased mood and a sense of connection serve
to temporarily mitigate the pain of societal rejection and resultant self-hatred. The
increased mood and sense of connection as a result of sex and finding an identity
are also evident. Finally, the cognitive distortions and decrease in intelligent

76
thought are also evident in many bug chasers. The tacit sense of badness that
develops from feeling socially excluded and discriminated against because of
sexuality then becomes expressed through bug chasing behavior.
Further research to test this theory is necessary. It will be useful for
further researchers to investigate the level of internalized homophobia in those
individuals that engage in bug chasing behavior. If a correlation exists between
these factors and the desire to seroconvert then the responsibility for the
prevention and treatment of bug chasing needs to expand beyond individual into a
larger fight against the social exclusion of MSM. Therefore, it is suggested that a
future researcher investigate factors underlying the behaviors of individuals who
engage in bug chasing and those who don’t on levels of internalized homophobia
and perceived social exclusion. Other factors that were not measured in this study
and that may be useful to understand include where the subjects are in the process
of coming out to friends and family, the degree to which they feel socially
connected and supported by others, and whether or not they feel a sense of pride
or connection to their sexuality.
It is essential to note that a very small percentage of gay men actually
identify as and engage in bug chasing behavior. Given the shocking nature of the
behavior it is likely it receives an excessive amount of negative publicity and may
in fact contribute to some of the negative attitudes about men who have sex with
men. It is important that researchers and media organizations that investigate bug

77
chasing do not do further damage in their attempt to understand this maladaptive
coping behavior. Although it is clear that only a very small number of people
actually engage in bug chasing, the research is clear that it is a true phenomenon
that does exist. However, to put it into perspective:
the proportion of gay men primarily behaving safely-which means
different things in different studies, but tends to equate somewhat
misleadingly with using condoms-commonly hovers between 60
and 70 percent; by contrast, the percentage of heterosexual women
and men practicing safe sex rarely attains a third of the sample
(Halperin, 2007, p. 13).
Perhaps some of the outcry regarding bug chasing is that it is a phenomenon in
the gay community. What is not discussed is whether this behavior exists within
the heterosexual community. If social exclusion and internalized homophobia are
factors in bug chasing, it is likely that it is even more rare in the heterosexual
community. Furthermore, what is not explained by this theory are the millions of
gay men who are not engaged in bug chasing. What merits further discussion are
the factors that contribute to a healthy sense of identity and resiliency in the face
of bigotry and discrimination.

78
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