Perceptions of HIV transmission risk in commercial and public sex venues

Background

Sexual behaviors of men who have sex with men (MSM) that occur in sexually charged venues (e.g., bathhouse, sex club, public park) are a target for research and intervention due to concerns about the role these venues may have in the transmission of HIV and other sexually transmitted infections (STIs). However, these efforts often exclude how individuals perceive HIV risk in terms of sex venue use. This paper analyzes how venue-specific perceptions of HIV transmission risk differ across venues and by onsite sexual behavior.

Method

Cross-sectional data collected using an Internet survey completed by 139 MSM who attended at least one sex venue (e.g., bathhouse, sex club, gym/health club, public park) in the past month.

Results

Risk perceptions were highest for bathhouses and sex clubs, though no significant differences were detected between any of the venues. With few exceptions, men who reported not engaging in sex or low-risk behaviors (i.e., masturbation or mutual masturbation) during venue attendance perceived higher risks than those who engaged in high-risk behaviors (i.e., anal sex). Interestingly, risk perceptions of public bathrooms, parks, and video/buddy booths were lower for attendees who reported unprotected oral sex with ejaculation than men who reported safer or riskier behaviors.

Conclusion

These findings provide important insights into how MSM perceive HIV risk in sex venues and highlight a need for expanded outreach and education in locations where sexual risk taking may be underestimated.