Diane Binson, PhD, William J. Woods, PhD, Lance Pollack, PhD, Jay Paul, PhD, Ron Stall, PhD, MPH, and Joseph A. Catania, PhD, Differential HIV Risk in Bathhouses and Public Cruising Areas, (Am J Public Health 2001; 91:14821486)

Categories

• Homophobia
• Prevention and Sexual Health

Resource Type

Research/Journal Articles  

Description

This article may be useful in considering the regularly-revived call to shut down bathhouses to reduce the rate of HIV transmission among men who have sex with me. The following abstract is taken from the article: Objectives. This report investigates differences in risk behaviors among men who have sex with men (MSM) who went to gay bathhouses, public cruising areas, or both. Methods. We used a probability sample of MSM residing in 4 US cities (n = 2881). Results. Men who used party drugs and had unprotected anal intercourse with nonprimary partners were more likely to go to sex venues than men who did not. Among attendees, MSM who went to public cruising areas only were least likely, and those who went to both public cruising areas and bathhouses were most likely to report risky sex in public settings. Conclusions. Distinguishing between sex venues previously treated as a single construct revealed a significant association between pattern of venue use and sexual risk. Targeting HIV prevention in the bathhouses would reach the segment of men at greatest risk for HIV transmission. The authors state in conclusion, in part: We know that baths are places where prevention efforts can actually find a majority of the men who have risky sex, and they are places where sex occurs, sometimes unprotected sex. This fact is particularly noteworthy, given that HIV prevention programs have not successfully reached men at highest risk for HIV transmission. Further, HIV interventions proximate to sexual activity probably have the best chance of being successful. Conducting HIV prevention in baths would reach bathers, but also the men who report the most risky behavior, multivenue users. Although we know that many US baths distribute condoms, lubrication, and HIV information, and a few provide counselors and special events related to safer-sex skills building,3 there is no evidence of the efficacy of these interventions. More important, we need to begin to investigate how manipulating the physical structure of the environment. Although the data suggest an interaction between the environment and the individual, they are not sufficient to identify the particular characteristics that contribute to the interaction. Until these are identified, we cannot develop, implement, or test those prevention efforts that are most likely to be effective in reducing HIV transmission among MSM. Thus, although prevention programs that address the individual need to continue, the challenge in the next generation of prevention efforts is to unravel the complex interaction between individual characteristics and the environment. For more information about the complete report, please submit an inquiry to info@hivlawandpolicy.org.  

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Published

2001-September-01