Marlon M. Bailey takes to task the epidemiological surveillance of unprotected sex among black gay men within HIV/AIDS prevention discourses and institutions. Drawing on interviews and analyses of black gay men’s profiles on gay sex websites, Bailey demonstrates how aims to prevent hiv transmission are undermined because they fail to encompass black gay male sexual pleasure and desire. Arguing for a move beyond a reductive causal relationship between sexual behavior and contagion that buttresses an always already pathologized and surveilled black queer sexuality, Bailey proposes a black queer theoretical framework as a way to reconceptualize prevention methods and discourse in health care. Given the struggles within structures of systemic racism, classism, and homophobia, black queer men, are always already “at risk”; unprotected sex is a risky behavior that at least provides them with a form of intimacy and affection that they do not otherwise receive.