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Bathhouses Can Be Good Venues for HIV Testing and Linkage to Care

Bathhouses frequented by gay and bisexual men may be good places to find people with undiagnosed HIV or other sexually transmitted diseases and encourage them to enter ongoing care, researchers reported in the February 1, 2012, Journal of Acquired Immune Deficiency Syndromes.

This week's observation of National HIV Testing Day raises awareness of the importance of regular testing, highlighting the fact that an estimated 1 in 5 individuals with HIV are unaware that they are infected.

In an effort to close this gap, public health workers are interested in finding new ways to reach people who are not likely to know their HIV serostatus. This is particularly urgent for men who have sex with men (MSM) -- especially young and African-American men -- who have the highest rates of new infection.

Kenneth Mayer from Brown University and Fenway Health and colleagues reported findings from an outreach program with HIV and sexually transmitted disease (STD) testing conducted at a bathhouse in Providence, RI, between 2004 and 2010.

Results

• During this time, a total of 1155 MSM underwent testing.
• Testing revealed the following prevalence rates, or total infections detected:
  • HIV: 2.3%;
  • Hepatitis C virus antibodies: 2.2%;
  • Syphilis: 2.0%;
  • Urethral chlamydia: 1.3%;
  • Urethral gonorrhea: 0.1%.
• 43.2% of the men tested reported unprotected anal intercourse during the preceding 2 months.
• A majority, however, said they thought that their behavior did not put them at increased risk for HIV or other STDs.
• In a multivariate analysis, men who had unprotected anal intercourse were more likely to have had sex with HIV positive or unknown status partners, to have sex while under the influence of drugs, to find sex partners via the Internet, and to have a primary male partner.
• Men newly diagnosed with HIV or syphilis tended to be older than age 30 and were more likely to have had a prior STD diagnosis and to meet partners through the Internet.
• For 10.5% of the men, the bathhouse test was the first time that they had ever been screened for HIV.
• Among 24 men who were newly diagnosed with HIV, all but 1 were successfully linked to care.

"These data suggest that offering HIV and STD testing in a bathhouse setting is effective in attracting MSM who are at increased risk for HIV and/or STD acquisition or transmission," the study authors concluded.

6/29/12

Reference

K Mayer, R Ducharme, N Zaller, et al. Unprotected Sex, Underestimated Risk, Undiagnosed HIV and Sexually Transmitted Diseases Among Men Who Have Sex with Men Accessing Testing Services in a New England Bathhouse. Journal of Acquired Immune Deficiency Syndromes 59(2):194-198. February 1, 2012.