Addressing Bug Chasers

There is a growing problem within the community, particularly within that of MSM (men who have sex with men). It isn't necessarily HIV but, if things continue, it could be the next outbreak. 

The increasingly common underbelly of the MSM community is that of bug chasers - persons seeking out HIV and not taking PrEP.

What is a bug chaser?

Bug chasers are often in search of someone who will be a gift giver, the person with a known HIV diagnosis who is intentionally not adhering to meds so his viral load will increase and he is more likely to pass HIV on to the chaser.

They often have parties in which "gifts" are "exchanged" with multiple partners.  While this trend may seem alarming, the sex-positive framework of my therapy practice helps me resolve at least some of this in my own mind. The parties are consensual adults. 

Aspects of bug chasing that concern me

But, there are still some elements that concern me.

1. The longer the gift giver has been off the meds, the more likely he is to be resistant to them. This means that if/when he does pass HIV along, he is also passing along resistance to the medicine. The bug chaser who ends up poz will have fewer and, potentially, harsher medicine options. The same goes for the gift giver when his CD4 (helper T-cell) count gets too low and he has to go on meds again. He can't resume his old regiment.

2. Strengthening the immunity of the virus against medicine is dangerous for the community as a whole.HIV is a retrovirus, which means that it can change over time to adapt to its surroundings, particularly if it isn't being actively attacked. What happens to our community if and when a strain of HIV becomes resistant to PrEP because its main ingredient is in almost all HIV regimens?

3. Other STIs are being spread this way, as well. If you can catch HIV from sexual activity, you can catch any other STI in that instance.

4. The same people who are engaging in this behavior are in online forums simultaneously talking about how they are not worried about coronavirus and are still engaging in random and/or group condomless (i.e. "bareback") sex.  Many comments equate the two; it is as though coronavirus is a badge of honor on the way to getting HIV. They are risking not only their own lives but also those of the community as a whole.

How do we address this without being judgmental?

If we are to support the rights of our fellow adult humans, we have to find a way to address this without being judgmental, even if it is alarming when looking at potential long-term systemic effects. 

We must remember that:^1-3

• All behavior serves functions
• Learning happens differently for each of us due to different learning histories
• Humans are generally attempting to do their best even when it doesn't make sense to others

Thus, this is about framing and understanding on all sides.

Generate empathy

If a bug chaser asks you to "give the gift," it can be a very confusing/upsetting moment -- we know that it isn't a walk in the park. But we can also generate some empathy; these humans don't know what they don't know.

They can't foresee some of the things that make our lives difficult. They aren't living in the AIDS crisis so they haven't lost friends to opportunistic infections. They think HIV is a free pass to stop using condoms and give into pleasures because that's what their peers in these online forums are telling them. And if this is true in their minds, then why be mad?

Recognize where the discomfort is coming from

Instead, we can take that discomfort, that initial upset, and recognize that it is likely tied to our own histories and worries about the future for this HIV-negative human and for the MSM community. We can remember that, even when someone seems ignorant or reckless, it isn't often their intent - they see value in their behavior. 

We can then also recognize that if we attack them, they aren't going to want to hear something that counters their reality, especially if it comes from an aggressor.  They will likely block us and move on.  This makes us feel better in the moment, but it does nothing to stop the movement.

We can always block them, and again this makes us feel better in the moment, which is valid and is a perfectly fine stopping point.

How we can make a change

But if we want to make a change, one thing we can do is lead their logic. Help them learn and understand by being humans, conversing about our own experiences -- and without implying theirs will be the same.  For instance, "I totally get it -- being barebacked feels good, no doubt.  I would do it, too, but I don't want my meds to stop working.  It really sucks this virus is so unique that it can adapt to beat the meds, especially from gift givers, who actively build up resistance against their meds."

The above line is one of many possibilities and has worked well for me on most occasions. When it hasn't, I recognize that I choose my own battles and, if I have given this a try, I'm not going to stress by pushing further. No one wants to be forced into learning, anyway.

We are not obligated to help

We do not have an obligation to help these persons or to help our community stay safe -- unless we wish to do that responsibility. Just know that, if a bug chaser does hit you up, and you feel strongly about it, you are not alone and you do have options in how you respond. 

Hopefully, this article helps in the event you do decide to chat with one. Or if nothing else, maybe this writing will have brought you some empathy for these humans as they navigate their own sexualities.