An HIV testing program at a New England bathhouse revealed a high prevalence of sexually transmitted infections — and a major disconnect between behavior and risk perception.
Bathhouses have been a target of scrutiny in the U.S. since the dawn of the HIV epidemic among men who have sex with men (MSM). These commercial sex venues are considered to be important drivers of HIV transmission, but they also provide a unique opportunity for real-time prevention. In the present study, researchers describe the risk practices and risk perceptions of MSM who underwent testing for HIV and other sexually transmitted infections (STIs) at a New England bathhouse.
A total of 1155 men underwent testing between mid-2004 through late 2009. The prevalence of HIV infection was 2.3%; syphilis, 2.0%; hepatitis C virus infection, 2.2%; genitourinary chlamydia, 1.3%; and genitourinary gonorrhea, 0.1%. Most of the men had primary care providers but said they would not feel comfortable being tested by them or even sharing HIV or STI test results with them. Of the 24 men with newly diagnosed HIV infection, 23 were successfully connected to care.
Only 44% of the men who underwent testing completed a questionnaire about risk behavior and risk perceptions. High-risk behaviors, such as unprotected anal sex, were commonly reported, but only 25% to 35% of the men who engaged in these activities believed they were at high risk for HIV infection.
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