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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

Mayer, Kenneth H. MD*,†,‡; Ducharme, Robert BA; Zaller, Nickolas D. PhD; Chan, Philip A. MD; Case, Patricia ScD, MPH*; Abbott, David BS§; Rodriguez, Irma I. MS; Cavanaugh, Timothy MD

JAIDS Journal of Acquired Immune Deficiency Syndromes: February 1st, 2012 - Volume 59 - Issue 2 - p 194–198
doi: 10.1097/QAI.0b013e31823bbecf
Epidemiology and Prevention

Abstract: American men who have sex with men (MSM) continue to have increased rates of HIV and sexually transmitted diseases (STD). Between 2004 and 2010, 1155 MSM were tested for HIV and/or STDs at Providence, RI bathhouse. The prevalence of HIV was 2.3%; syphilis, 2.0%; urethral gonorrhea, 0.1%; urethral chlamydia, 1.3%; 2.2% of the men had hepatitis C antibodies. Although 43.2% of the men engaged in unprotected anal intercourse in the prior 2 months, the majority of the men thought that their behaviors did not put them at increased risk for HIV or STDs. Multivariate analyses found that men who engaged in unprotected anal intercourse were more likely to have had sex with unknown status or HIV-infected partners; have sex although under the influence of drugs; tended to find partners on the internet; and were more likely to have a primary male partner. Men who were newly diagnosed with HIV or syphilis tended to be older than 30 years; had sex with an HIV-infected partner; had a prior STD diagnosis; and met partners on the internet. For 10.5% of the men, bathhouse testing was the first time that they had ever been screened for HIV. Of 24 men who were newly diagnosed with HIV infection, only 1 was not 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 Fenway Institute, Boston, MA

The Miriam Hospital, Providence, RI

Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

§AIDS Project Rhode Island, Providence, RI

Private Practice, Pawtucket, RI

Correspondence to: Kenneth H. Mayer, MD, The Fenway Institute, 1340 Boylston Street, Boston, MA 02115 (e-mail:

This research has been facilitated by the infrastructure and resources provided by the Lifespan/Tufts/Brown Center for AIDS Research, an NIH funded program #P30 AI42853; and grants from the Rhode Island Department of Health and the Massachusetts Department of Public Health.

Presented as “Mayer K. H., Ducharme R, Abbott D, Cavanaugh T. HIV and Sexually Transmitted Infection (STD) Screening in a Providence Bathhouse: Opportunities for Education, Prevention and Improving Men's Health” at the 2007 National HIV Prevention Conference, Centers for Disease Control and Prevention, December 2–5, 2007, Atlanta, GA.

The authors have no conflicts of interest to disclose.

Received April 27, 2011

Accepted September 13, 2011

© 2012 Lippincott Williams & Wilkins, Inc.