HIV risk associated with gay bathhouses and sex clubs: findings from 2 seattle surveys of factors related to HIV and sexually transmitted infections

Abstract

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.

FIGURE 1

Frequency of sexual risks and drug use, by commercial sex venue site: Seattle, WA, 2004. Note. UDS = unknown or discordant HIV status. Nitrite inhalants are nitrate inhalants. Sexual behaviors during current commercial sex venue visit; drug use in previous 24 hours. Also, statistically significant crude associations were observed between both crystal methamphetamine use and UAI, and nitrite inhalants use and UAI. ^aStatistically significant (P < .05) difference between sex club and bathhouse A. ^bStatistically significant (P < .05) difference between sex club and bathhouse B. ^cStatistically significant (P < .05) difference between bathhouse A and bathhouse B.