ABSTRACT
Since the human immunodeficiency virus (HIV) was first identified in 1981, its spread has been largely associated with unprotected sexual intercourse. Early in the pandemic, the spread of the disease was believed to be confined to homosexual men, and indeed was represented as being somehow peculiar to so-called ‘gay sex,’ as if heterosexuals never have more than one sexual partner and never engage in anal intercourse.1 The early association between the in cidence of this disease and certain kinds of sexual behaviour, notably ‘deviant’ sexual behaviour, resulted in an enormous expansion in the study of sexual behaviour. Indeed, it is probably fair to say that a substantial part of virtually every dollar that is spent in AIDS prevention research, even in areas in which drug injection is prevalent, includes an examination of some aspect of sexual behaviour. One would think that nearly ten years later, after the expenditure of tens of millions of dollars, that we would have acquired a clearer understanding of the nature of the sexual behaviours that are associated with the spread of this disease. Minimally, one would expect that we would at least have a better understanding of what the questions ought to be, and how to best go about trying to resolve them. It is the thesis of this chapter, however, that we are not much closer now to understanding how to foster sexual
risk reduction than we were ten years ago. Indeed, the discussion which follows is aimed at showing how we have been asking the wrong questions about sexual risk behaviour, and often, asking them in a manner that is ill-suited to the complex nature of the behaviours themselves. In some sense, the latter methodological problem is antecedent to the former, which might be said to be more fundamentally conceptual in nature, and so that is where the discussion begins.
