Men Who Have Sex With Men And Visit Bathhouses More Likely to Engage in Unprotected Sex

Men who have sex with men and who go to venues such as sex clubs and bathhouses are more likely to engage in "risky" sexual behavior than men who frequent only "public cruising areas" such as parks or beaches, according to a new study in the September issue of the American Journal of Public Health. The study, which was conducted by Diane Binson and colleagues at the Center for AIDS Prevention at the University of California-San Francisco, included 2,478 men who reported having had sex with another man within the past 12 months. Participants were asked questions regarding how often in the past year they had gone to a "sex venue" -- either a bathhouse or a public cruising area -- and were asked whether they engaged in unprotected anal intercourse. Approximately 50% of the participants reported going to a sex venue; of these, 39% said they went "only" to public cruising areas ("cruisers"), 25% said they went only to bathhouses or sex clubs ("bathers") and 36% said they went to both types of venues (multivenue users). Among the study findings:

• Bathers and multivenue users were more likely than cruisers to be HIV-positive, although HIV status was self-reported in the study. Nearly 25% of multivenue users reported being HIV-positive, compared to 21.2% of bathers and 13.1% of cruisers.
• Multivenue users were the most likely to report engaging in unprotected anal sex. Fifty percent of multivenue users said they had engaged in unprotected anal sex with a "nonprimary partner," compared to 33.9% of bathers and 20% of cruisers.

Bring Messages to the Bathhouses
Binson and colleagues concluded that the study results "suggest that sex venues play an important role in the sexual lives of gay men." Multivenue users were the most likely to report "risky behavior," and cruisers were the least likely to have engaged in risky behavior. Although the researchers warn that because the study assessed risk behavior, the data "emphasized the minority of men who engaged in risky behavior in these venues," the report also indicates a "significant association between individual characteristics, venue type and risk behavior." The researchers state that since HIV prevention programs "proximate to sexual activity probably have the best chance of being successful," health officials should conduct HIV prevention programs in bathhouses. Such programs "would reach bathers, but also the men who report the most risky behavior, multivenue users," they conclude (Binson et al., American Journal of Public Health, September 2001). The study is available online.