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AJPH First Look, published online ahead of print Feb 12, 2009
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AJPH.2007.130773v1
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April 2009, Vol 99, No. S1 | American Journal of Public Health S165-S172
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2007.130773

RESEARCH AND PRACTICE

HIV Risk Associated With Gay Bathhouses and Sex Clubs: Findings From 2 Seattle Surveys of Factors Related to HIV and Sexually Transmitted Infections

William J. Reidy, PhD, Freya Spielberg, MD, MPH, Robert Wood, MD, Diane Binson, PhD, William J. Woods, PhD and Gary M. Goldbaum, MD, MPH

At the time of the study, William J. Reidy was a doctoral student with the Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle. Freya Spielberg was with the Department of Family Medicine, University of Washington, Seattle. Robert Wood is with Public Health—Seattle & King County HIV-AIDS Program, Seattle. Diane Binson and William J. Woods are with the Department of Medicine Center for AIDS Prevention Studies, University of California, San Francisco. Gary M. Goldbaum was with the Public Health—Seattle & King County HIV-AIDS Program, Seattle.

Correspondence: Requests for reprints should be sent to William J. Reidy, Columbia University International Center for AIDS Care and Treatment Programs, 722 West 168th St, 7th Floor, New York, NY (e-mail: wr2205{at}columbia.edu).

Objectives. We studied the HIV risk behaviors of patrons of the 3 commercial sex venues for men in Seattle, Washington.

Methods. We conducted cross-sectional, observational surveys in 2004 and 2006 by use of time–venue cluster sampling with probability proportional to size. Surveys were anonymous and self-reported. We analyzed the 2004 data to identify patron characteristics and predictors of risk behaviors and compared the 2 survey populations.

Results. Fourteen percent of respondents reported a previous HIV-positive test, 14% reported unprotected anal intercourse, and 9% reported unprotected anal intercourse with a partner of unknown or discordant HIV status during the current commercial sex venue visit. By logistic regression, recent unprotected anal intercourse outside of a commercial sex venue was independently associated with unprotected anal intercourse. Sex venue site and patron drug use were strongly associated with unprotected anal intercourse at the crude level. The 2004 and 2006 survey populations did not differ significantly in demographics or behaviors.

Conclusions. Patron and venue-specific characteristics factors may each influence the frequency of HIV risk behaviors in commercial sex venues. Future research should evaluate the effect of structural and individual-level interventions on HIV transmission.






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