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Miller, write that for a behavior to be barebacking two crucial criteria must be met: intentionality, and the potential for the risk of viral transmission. What made our approach unique was that ESS addressed the specific problems of helping gay and bisexual men change their sexual behaviors using a psychosocial and psychoeducational approach that was designed specifically to be a sexual enhancement workshop for gay men — at a time when fear of sex changed their sex lives for the worse.
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