The book begins with an introduction section titled "Confessions of a Barebacker", which explains Dean's role as a
participant-observer during the sociological investigation of the themes. As a general text, the book discusses the emergence of the barebacking
subculture among gay men in
San Francisco during the 1990s. and how this cultural development coincided with the scientific invention of
highly active antiretroviral therapy (HAART) as a treatment for
HIV that significantly reduced the health impacts from the
AIDS condition, turning it into a
chronic illness to be controlled via medication. These improvements led to a reduction in the stringency of
condom use within the gay community and the creation of the barebacking subculture. While contemplating the reasons behind the subculture's formation, Dean puts forward the concept of barebacking as the "culmination of some men’s desires to explore beyond their usual boundaries" and that their sexual practices allow them to create
unlimited intimacy. This idea is put at odds against prior research into the subject and uses psychoanalysis to explain how members of the subculture can't be pidgeonholed into a specific definition. Though Dean, at the same time, criticizes limitations placed on sexual encounters that prevents the potential of his intimacy concept from being achieved due to rules and role constraints within the gay male community. After addressing the history of the subculture, Dean's work also investigates the topic using an
ethnological viewpoint that treats the group of individuals studied as a "foreign culture" that has no moral judgements attached or intended. This allowed the author to then document the "language, rituals, etiquette, institutions, [and] iconography" of the subculture. Continuing the discussion of pornography, but from a more
kink-based perspective, the third chapter titled "Viral Fetishism, Visual Fetishism" looks into how social taboos have been presented in gay pornographic films. The final chapter titled "Cruising As a Way of Life" discusses how sexual encounters between gay men in modern times, especially with the proliferation of online options, have become less as interactions with others and more "planned as if ordering from a takeout menu". Instead of being focused on as an ethical decision, regardless of moral opinions on the subject,
cruising has become focused on
object-relating for personal characteristics and sexual interests. ==Critical reception==