In the San Francisco study, fewer men reported engaging in barebacking when the behavior was defined as intentional unprotected anal intercourse with a non-primary partner.Using this definition, 14% of the 390 men who were aware of barebacking reported engaging in the behavior in the past two years.Halkitis and Richard Wolitski also found that HIV-positive MSM were more likely to have bareback sex than were HIV-negative MSM.

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Brennan explored the stigma attached to the practice, in particular narratives of 'disposal and disgust' that became associated with the performer, and contributed to a decline in his career.

Bareback gay pornography was standard in "pre-condom" films from the 1970s and early 1980s.

This poses no risk of infecting an HIV-negative person newly with HIV (though it can cause infection with a new strain of HIV, hastening disease progression).

On this account, barebacking could be considered an early harm reduction strategy, similar to serosorting, which was later endorsed by some public health authorities in the USA.

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As AIDS emerged and the sexual transmission of HIV became known in the 1980s, the use of condoms to prevent infection became much more widespread, especially among men who have sex with men (MSM) who engage in anal sex.