Bareback sex is physical sexual activity, especially sexual penetration, without the use of a condom. The topic primarily concerns anal sex between men who have sex with men without the use of a condom, and may be distinguished from unprotected sex because bareback sex denotes the deliberate act of forgoing condom use. Etymology An LGBT slang term, bareback sex comes from the equestrian term bareback, which is the practice of riding a horse without a saddle. It is not known when the term (as sexual slang) was first used, although its use did gain momentum in the 1960s with the first appearance in print (as analogous reference) occurring in 1968. The term was used by G.I.s during the Vietnam War when sex without the use of a condom was known as "going in" or "riding" bareback. The term was included in the 1972 publication, Playboy's Book of Forbidden Words: A Liberated Dictionary of Improper English. The term appeared occasionally in print until the 1980s and then in context to the AIDS epidemic and the discussion of sexual practices. It did not have widespread use in LGBT culture until 1997, when there was an increase of discussion regarding condomless sex (as reflected in print publications). The term bareback sex is now used less frequently among heterosexuals. A 2009 survey by the New York City Department of Health and Mental Hygiene found that heterosexual women are more likely to have unprotected anal intercourse than gay and bisexual men. History and culture Initially used for contraceptive purposes, condoms also came to be used to limit or prevent sexually transmitted infections (STIs/STDs), even after other contraceptive methods were developed. 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. At the beginning of the AIDS crisis, in the context of the invention and development of safe sex, the uptake of condoms among Western MSM was so widespread and effective that condom use became established as a norm for sex between men. From 1995, several high-profile HIV positive men declared their refusal to wear condoms with other HIV positive men in gay publications, dubbing the practice barebacking. While these early articulations of barebacking expressed a concern for HIV prevention, in that they generally referred to dispensing