HIV This Week

Woods WJ, Binson D, Blair J, Han L, Spielberg F, Pollack LM. Probability sample estimates of bathhouse sexual risk behavior. J Acquir Immune Defic Syndr. 2007 Jun 1;45(2):231-8.

Previous research links high rates of unprotected anal intercourse with men who go to bathhouses; however, the literature provides no prevalence estimates. An exit survey of a probability sample was conducted to describe the prevalence of risk activity at the bathhouse. Data are from a 2-stage probability sample of men exiting a gay bathhouse (n = 400). During their visit, 91.5% of men had oral sex and 44.2% had anal sex (11.1% reported unprotected anal intercourse and 5.5% reported unprotected receptive anal intercourse). In the prior 3 months, 85% reported having anal sex, which was more likely to be unprotected when it occurred in a private home or hotel as opposed to a public setting (P < 0.001). Moreover, having unprotected anal intercourse at home was a significant correlate of risk during the bathhouse visit (P < 0.001). Most men at the bathhouse engaged in oral sex rather than anal sex, and most anal sex included use of condoms. Furthermore, men were more likely to have unprotected anal intercourse in a private home than in any public setting. The bathhouse seems to have facilitated condom use when anal sex occurred on-site.

Editors’ note: The findings of this study from western USA may be surprising given the associations with risk behaviour that the concept of a bathhouse may evoke. Social and safer sexual norms have been changing and some environments can reinforce and support these changes. Other environments may provide a false sense of security and may be associated with more risk than might be at first thought. Learning more about the interplay between risk and environment can assist in the design of HIV risk reduction strategies among gay men.

Bolding G, Davis M, Hart G, Sherr L, Elford J. Where young men who have sex with men meet their first sexual partner: the role of the Internet. AIDS Behav. 2007 Jul;11(4):522-6.

The objective was to examine how many young men who have sex with men (MSM) meet their first sexual partner through the Internet and whether this has increased over time. In 2003, 2505 MSM surveyed on UK Internet sites completed a self-administered questionnaire. Data were analysed for 810 MSM who were under 30 years old at the time of the survey and who first had sex with another man between 1993-2002. During this period there was a significant increase in the percentage of MSM who met their first male sexual partner through the Internet (2.6-61.0%). There was a corresponding decrease in the percentage who met their first sexual partner at a gay venue (34.2-16.9%), school (23.7-1.3%), a public sex environment, through small ads or telephone chatlines (10.5-1.3%). An increasing number of young MSM appear to meet their first sexual partner through the Internet. Online sexual health interventions should be developed targeting men early in their sexual careers.

Editors’ note: Self-administered questionnaires for men who are accessing the internet already may reveal higher rates of internet use for sex than in the overall population of men who have sex with men. What is of interest here is the tremendous increase in the numbers of young men who are organising their first sexual experience through the internet rather than at gay venues, at school, through newspaper ads or on telephone chat-lines. Using the internet for sexual health promotion among young gay men would be the next logical step.