AIDS and Behavior

, Volume 11, Issue 6, pp 915–926 | Cite as

Sexual Risk Behavior and Venues for Meeting Sex Partners: An Intercept Survey of Gay and Bisexual Men in LA and NYC

  • Christian Grov
  • Jeffrey T. Parsons
  • David S. Bimbi
Original Paper

Abstract

Understanding the link between venues for meeting sex partners and sexual risk behavior is critical to developing and placing effective sexual health education and HIV prevention services. Non-monogamous gay and bisexual men (n = 886) were surveyed in New York and Los Angeles about the venues that they met recent sex partners: bathhouses, private sex parties, gay bars/clubs, the gym, via public cruising, and the Internet. Bars/clubs, bathhouses, and the Internet were the most endorsed venues for meeting partners. Men having met a majority of their partners (i.e., “preference”) via these three venues were compared/contrasted. Those having preference for bars/clubs were dissimilar from men with preference for bathhouses or the Internet on multiple levels (e.g. age, number of sex partners, temptation for unsafe sex). However, these men were proportionally similar in whether they had engaged in a recent episode of unprotected anal intercourse (UAI). Logistic regressions predicting UAI suggested venues might not play a role in differentiating men who had preference for bars/clubs, bathhouses or the Internet. Additional regression analyses utilizing all six venues to predict UAI suggested other person-factors such as identity as a barebacker and temptation for unsafe sex better explain UAI. This research suggests HIV prevention and educational campaigns targeted within venues need also address socio-psychological person-factors in addition to environmental/venue contexts.

Keywords

Gay Bisexual MSM Sex venue location Risk Internet Bathhouse Cruising Club Bar Gym HIV 

Notes

Acknowledgments

The Sex and Love v2.0 Project was supported by the Hunter College Center for HIV/AIDS Educational Studies and Training (CHEST), under the direction of Dr. Parsons. The authors acknowledge the contributions of other members of the CHEST Sex and Love v2.0 Project Team–Gideon Feldstein, Catherine Holder, James Kelleher, and Juline A. Koken. The authors also wish to thank Sarit A. Golub and the anonymous reviewers for their helpful comments.

References

  1. Baker, P. (2002). Fantabulosa: A dictionary of polari & gay slang. New York: Continuum.Google Scholar
  2. Benotsch, E. G., Kalichman, S., & Cage, M. (2002). Men who have met sex partners via the Internet: Prevalence, predictors, and implications for HIV prevention. Archives of Sexual Behavior, 31, 177–183.PubMedCrossRefGoogle Scholar
  3. Benotsch, E., Seeley, S., Mikytuck, J. J., Pinkerton, S. D., Nettles, C. D., & Ragsdale, K. (2006). Substance use, medications for sexual facilitation, and sexual risk behavior among traveling men who have sex with men. Sexually Transmitted Diseases, 33(12), 706–711.PubMedCrossRefGoogle Scholar
  4. Binson, D., Woods, W. J., Pollack, J., Paul, J., Stall, R. & Catania, J. A. (2001). Differential HIV risk in bathhouses and public cruising areas. American Journal of Public Health, 91, 1482–1486.PubMedGoogle Scholar
  5. Binson, D., Woods, W. J., Pollack, L., & Sheon N. (2005). Bringing HIV/STI testing programmes to high-risk men. International Journal of STD & AIDS, 9, 600–604.CrossRefGoogle Scholar
  6. Blank, S., Gallagher, K., Washburn, K., & Rogers, M. (2005). Reaching out to boys at bars: Utilizing community partnerships to employ a wellness strategy for syphilis control among men who have sex with men in New York City. Sexually Transmitted Diseases, 32, s65–s72.PubMedCrossRefGoogle Scholar
  7. Bolding, G., Davis, M., Hart, G., Sherr, L., & Elford, J. (2005) Gay men who look for sex on the Internet: Is there more HIV/STI risk with online partners? AIDS, 19, 961–968.PubMedCrossRefGoogle Scholar
  8. Bolding G., Davis M., Sherr L, Hart G., & Elford J. (2004). Use of gay Internet sites and views about online health promotion among men who have sex with men. AIDS Care, 16(3), 993–1001.PubMedCrossRefGoogle Scholar
  9. Bull, S., Lloyd, L., Rietmeijer, C., & McFarlane, M. (2004). Recruitment and retention of an online sample for an HIV prevention intervention targeting men who have sex with men: the smart sex quest project. AIDS Care, 16, 931–943.PubMedCrossRefGoogle Scholar
  10. Bull, S. S., & McFarlane, M. (2000). Soliciting sex on the Internet: What are the risks for sexually transmitted diseases and HIV? Sexually Transmitted Diseases, 27, 545–550.PubMedCrossRefGoogle Scholar
  11. Bullock, D. (2004) Lesbian cruising: an Examination of the concept and methods. Journal of Homosexuality, 47, 1–31.PubMedCrossRefGoogle Scholar
  12. Carey, M. P., Braaten, L. S., Jaworski, B. C., Durant, L. E., & Forsyth, A. D. (1999). HIV and AIDS relative to other health, social, and relationship concerns among low-income women: A brief report. Journal of Women’s Health and Gender Based Medicine, 8, 657–661.PubMedGoogle Scholar
  13. Centers for Disease Control, Prevention (CDC). (2002). Unrecognized HIV infection, risk behaviors, and perceptions of risk among young black men who have sex with men—Six US cities 1994–1998. MMWR, 51, 733–736.PubMedGoogle Scholar
  14. Centers for Disease Control and Prevention (CDC) (2003a). HIV/AIDS Surveillance Report: HIV Infection and AIDS in the United States. Accessed online on October 20, 2005 at http://www.cdc.gov/hiv/stats.htm#exposure.
  15. Centers for Disease Control and Prevention (CDC) (2003b). HIV/AIDS Surveillance Report: HIV Infection and AIDS in the United States, Table 18. Accessed Online on October 20, 2005 at http://www.cdc.gov/hiv/stats/2003SurveillanceReport/table18.htm.
  16. Centers for Disease Control and Prevention (CDC) (2005a). HIV/AIDS among men who have sex with men (MSM). Accessed online on October 20, 2005 at http://www.cdc.gov/hiv/pubs/facts/msm.htm.
  17. Centers for Disease Control and Prevention (CDC) (2005b). HIV/AIDS Surveillance Report, 2004. Vol. 16. Atlanta: US Department of Health and Human Services, CDC; 1–46. Also available at http://www.cdc.gov/hiv/topics/surveillance/resources/reports.htm. Accessed July 19, 2006.Google Scholar
  18. Chen, S. Y., Gibson, S., Katz, M. H., Klausner, J. D., Dilley, J. W., Schwarcz, S. K., Kellogg, T. A., & McFarland, W. (2002a). Continuing increases in sexual risk behavior and sexually transmitted diseases among men who have sex wiht men: San Francisco, Calif, 1999–2001. American Journal of Public Health, 92, 1387–1388.Google Scholar
  19. Chen, J. L., Kodagoda, D., Lawrence, A. M., & Kerndt, P. R. (2002b). Rapid public health interventions in response to an outbreak of syphilis in Los Angeles. Sexually Transmitted Diseases, 29, 285–287.CrossRefGoogle Scholar
  20. Chiasson, M., Hirshfield, S., Humberstone, M., Remien, R., Wolitski, R., & Wong, T. A. (2005). Comparison of online and offline risk in MSM. Paper presented at: 12th Conference on Retroviruses and Opportunistic Infections; February 25, 2005; Boston, MA.Google Scholar
  21. Chiasson M. A., Parsons J. T., Tesoriero J., Carballo-Dieguez, A., Hirshfield, S., & Remien, R. H. (2006) HIV behavioral research online. Journal of Urban Health, 83, 1–13.CrossRefGoogle Scholar
  22. Clatts, M. C., Goldsamt, L. A., & Yi, H. (2005). An emerging HIV risk environment: A preliminary epidemiological profile of an MSM Poz Party in New York City. Sexually Transmitted Infections, 81, 373–376.PubMedCrossRefGoogle Scholar
  23. Cohen, J. (2006, January 22, 2006). Protect or disinhibit? New York Times, p. 12.Google Scholar
  24. Costello, D. (2005, December 19, 2005). AIDS pill as party drug? Los Angeles Times, p. F1.Google Scholar
  25. Crosby, R., & Metty, A. (2004). A descriptive analysis of HIV risk behavior among men having sex with men attend a large sex resort. AIDS, 37, 1496–1499.Google Scholar
  26. Daniel, W. W. (1996). Biostatistics: A foundation for analysis in the health science. New York: Wiley.Google Scholar
  27. Ekstrand, M. L., Stall, R. D., Paul, J. P., Osmond, D. H., Coates, T. J. (1999). Gay men report high rates of unprotected anal sex with partners of unknown or discordant HIV status. AIDS, 13, 1525–1533.PubMedCrossRefGoogle Scholar
  28. Elford, J., Bolding, G., Davis, M., Sherr, L., & Hart, G. (in press). Barebacking Among HIV-Positive Gay Men in London. Sexually Transmitted Diseases.Google Scholar
  29. Elford, J., Bolding, G., & Sherr, L. (2001) Seeking sex on the Internet and sexual risk behaviour among gay men using London gyms. AIDS, 15, 1409–1415.PubMedCrossRefGoogle Scholar
  30. Elwood, W. N., & Greene, K. (2006). “Risks both known and unknown”: A qualitative method to assess the role of situation in HIV/STD Risk and Prevention. Journal of Homosexuality, 50, 135–154.CrossRefGoogle Scholar
  31. Elwood, W. N., Green, K., & Carter, K. K. (2003). Gentlemen don’t speak: Communication norms and condom use in bathhouses. Journal of Applied Communication Research, 31, 277–298.CrossRefGoogle Scholar
  32. Elwood W. N., & Williams, W. L. (1998). Sex, drugs, and situation: attitudes, drug use, and sexual risk behaviors among men who frequent bathhouses. Journal of Psychology and Human Sexuality, 10, 23–44.CrossRefGoogle Scholar
  33. Elwood, W. N., & Williams, M. L. (1999). The politics of silence: Communicative rules and HIV prevention issues in gay male bathhouses. In W. N. Elwood (Ed.), Power in the blood: A handbook on AIDS, politics, and communication (pp. 121–132). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
  34. Frankis, J. S., & Flowers, P. (2005). Men who have sex with men (MSM) in public sex environments (PSEs): A systematic review of quantitative literature. AIDS Care, 17, 273–288.PubMedCrossRefGoogle Scholar
  35. Frankis, J. S., & Flowers, P. (2006). Cruising for sex: Sexual risk behaviours and HIV testing of men who cruise, inside and out with public sex environments (PSE). AIDS Care, 18, 54–59.PubMedCrossRefGoogle Scholar
  36. Grov, C. (2004). “Make me your death slave:” Men who have sex with men and use the Internet to intentionally spread HIV. Deviant Behavior, 25, 229–349.CrossRefGoogle Scholar
  37. Grov, C. (2006). Barebacking websites: Electronic environments for reducing or inducing HIV risk. AIDS Care, 18, 990–997.PubMedCrossRefGoogle Scholar
  38. Halkitis, P. N., & Parsons, J. T. (2002). Recreational Drug Use and HIV-Risk Sexual Behavior among Men Frequenting Gay Social Venues. Journal of Gay & Lesbian Social Services, 14, 19–38.CrossRefGoogle Scholar
  39. Halkitis, P. N., & Parsons, J. T. (2003). Intentional unsafe sex (barebacking) among HIV-positive gay men who seek sexual partners on the Internet. AIDS Care, 15, 367–378.PubMedCrossRefGoogle Scholar
  40. Hirshfield, S., Remien, R., Humberstone, M., Walavalkar, I., & Chiasson, M. (2004) Substance use and high-risk sex among men who have sex with men: a national online study in the USA. AIDS Care, 16, 1036–1047.PubMedCrossRefGoogle Scholar
  41. Humphreys, L. (1975). Tearoom Trade: Impersonal sex in public places. Chicago, IL: Aldine Publisher Company. Google Scholar
  42. Kalichman, S. C., Benotsch, E., Rompa, D., Gore-Felton, C., Austin, J., Luke, W., DiFonzo, K., Buckles, J., Kyomugisha, F. & Simpson, D. (2001). Unwanted sexual experiences and sexual risks in gay and bisexual men: Associations among revictimization, substance use and psychiatric symptoms. Journal of Sex Research, 28, 1–9.Google Scholar
  43. Kalichman, S. C., Rompa, D., Luke, W., & Austin, J. (2002). HIV transmission risk behaviors among HIV-positive persons in serodiscordant relationships. International Journal of STD AIDS, 13, 677–682.PubMedCrossRefGoogle Scholar
  44. Kalichman, S. C., & Simbaya, L. (2004a). Sexual assault history and risks for sexually transmitted infections among women in an African township in Cape Town, South Africa. AIDS Care, 16, 681–689.CrossRefGoogle Scholar
  45. Kalichman, S. C., & Simbaya, L. (2004b). Traditional beliefs about the cause of AIDS and AIDS-related stigma in South Africa. AIDS Care, 16, 572–580.CrossRefGoogle Scholar
  46. Kellerman, S., Hutchinson, A., Begley, E., Boyett, B., Clark, H., & Sullivan, P. (2005, July). Knowledge and use of pre-exposure prophlaxis among attendees of minority gay pride events, 2004. Paper presented at the The 3rd IAS Conference on HIV Pathogenesis and Treatment, Rio de Janeiro, July 24–27 2005.Google Scholar
  47. Kim, A., Kent, C., McFarland, W., & Klausner, J. (2001) Cruising on the Internet highway. Journal of Acquired Immune Deficiency Syndrome, 28, 89–93.Google Scholar
  48. Klausner, J., Wolf, W., Fisher-Ponce, L., Zolt, I., & Katz, M. (2000). Tracing a syphilis outbreak through cyberspace. Journal of the American Medical Association, 284, 447–449.PubMedCrossRefGoogle Scholar
  49. Koblin, B. A., Torian, L. V., Gulin, V., Ren, L., MacKellar, D. A., & Valleroy, L. A. (2000) High prevalence of HIV infection among young men who have sex with men in New York City. AIDS, 14, 1793–1800.PubMedCrossRefGoogle Scholar
  50. Leap, W. L. (ed.) (1999) Public sex: Gay space. New York: Columbia University Press.Google Scholar
  51. Liau, A., Millett, G., & Marks, G. (2006). Meta-analytic examination of online sex-seeking and sexual risk behavior among men who have sex with men. Sexually Transmitted Diseases, 33, 576–584.PubMedCrossRefGoogle Scholar
  52. Lister, N. A., Smith, A., Sepehr, T. N., Garland, S., Hayes, P., & Fairley, C. K. (2005). Comprehensive clinical care on-site in men-only saunas: confidential STI/HIV screening outreach clinic. International Journal of STD & AIDS, 16, 794–798.CrossRefGoogle Scholar
  53. McFarlane, M., Bull, S., & Rietmeijer, C. (2000). The Internet as a newly emerging risk environment for sexually transmitted diseases. Journal of the American Medical Association, 284, 443–446.PubMedCrossRefGoogle Scholar
  54. Mettey, A., Crosby, R., DiClemente, R., & Holtgrave, D. (2003) Associations between internet sex seeking and STI associated risk behaviours among men who have sex with men. Sex Transmitted Infection, 79, 466–468.CrossRefGoogle Scholar
  55. Miller, K.W., Wilder, L.B., Stillman, F.A., & Becker, D.M. (1997). The feasibility of a street-intercept survey method in an African-American community. American Journal of Public Health, 87, 655–658.PubMedCrossRefGoogle Scholar
  56. Parsons, J. T. (2005). HIV-positive gay and bisexual men. In S. C. Kalichman (Eds) Positive Prevention: Reducing HIV Transmission among People Living with HIV/AIDS (pp. 99–133). New York: Kluwer.Google Scholar
  57. Parsons, J. T., & Halkitis, P. N. (2002). Sexual and drug-using practices of HIV-positive men who frequent public and commercial sex environments. AIDS Care, 14, 815–826.PubMedCrossRefGoogle Scholar
  58. Parsons, J. T., Halkitis, P. N., Bimbi, D. S., & Borkowski, T. (2000). Perceptions of the benefits and costs associated with condom use and unprotected sex among late adolescent college students. Journal of Adolescence, 23, 377–391.PubMedCrossRefGoogle Scholar
  59. Parsons, J. T., Halkitis, P. N., Wolitski, R. J., Gomez, C. A., the Seropositive Urban Men’s Study Team. (2003). Correlates of sexual risk behaviors among HIV-positive men who have sex with men. AIDS Education and Prevention, 15, 383–400.PubMedCrossRefGoogle Scholar
  60. Parsons, J. T., Vicioso, K., Punzalan, J. C., Halkitis, P. N., Kutnick, A., & Velasquez, M. M. (2004). The Impact of alcohol use on the sexual scripts of HIV+ men who have sex with men. Journal of Sex Research, 41(2), 160–172.PubMedGoogle Scholar
  61. Parsons, J. T., & Vicioso, K. (2005). Brief encounters: The roles of public and commercial sex environments in the sexual lives of HIV-positive gay and bisexual men. In P. Halkitis, C. Gómez, & R. J. Wolitski (Eds.) HIV Positive Sex: The Psychological and Interpersonal Dynamics of HIV-Seropositive Gay and Bisexual Men's Relationships (pp. 183–200). Washington, DC: American Psychological Association. Google Scholar
  62. Reece, M., & Dodge, B. (2003). Exploring the physical, mental and social well-being of gay and bisexual men who cruise for sex on a college campus. Journal of Homosexuality, 46, 111–136.PubMedCrossRefGoogle Scholar
  63. Rietmeijer, C. A., & Lloyd, L. V. (2005). Net, bath and beyond: Serosorting, unprotected anal intercourse, and gonorrhea among MSM who preferentially seek sex partners on the Internet, in Bathhouses, or in other environments. Paper presented at the 2005 National HIV Prevention Conference, Atlanta Georgia, June 12–15.Google Scholar
  64. Ross, M. (2005). Typing, doing, and being: Sexuality and the Internet. Journal of Sex Research, 42, 342–352.PubMedGoogle Scholar
  65. Rotheram-Borus, M. J., Mann, T., Newman, P. A., Grusky, O., Frerichs, R. R., Wight, R. G., & Kuklinski, M. (2001). A street intercept survey to assess HIV-testing attitudes and behaviors. AIDS Education and Prevention, 13, 229–238.PubMedCrossRefGoogle Scholar
  66. Silverstein, C., & Picano, F. (2003). The joy of gay sex. New York: Harpers Resource.Google Scholar
  67. Shernoff, M. (2005). Without Condoms: Unprotected sex, gay men, and barebacking. New York: Routledge.Google Scholar
  68. Stolte, I. G., Dukers, N. H., de Wit, J. B., Fennema, J. S., & Countinho, R. A. (2001). Increases in sexually transmitted infections among homosexual men in Amsberdam in relation to HAART. Sexually Transmitted Diseases, 77, 184–186.Google Scholar
  69. Taylor, M., Aynalem, G., Smith, L., Bemis, C., Kenney, K., & Kerndt, P. (2004). Correlates of Internet Use to Meet Sex Partners Among Men Who Have Sex With Men Diagnosed With Early Syphilis in Los Angeles County. Sexually Transmitted Diseases, 31, 552–556.PubMedCrossRefGoogle Scholar
  70. Tewksbury, R. (2002). Bathhouse intercourse: structural and behavioral aspects of an erotic oasis. Deviant Behavior, 23, 75–112.CrossRefGoogle Scholar
  71. Tewksbury, R. (2003). Bareback Sex and the Quest for HIV: Assessing the Relationship in Internet Personal Advertisements of Men Who Have Sex With Men. Deviant Behavior, 24, 467–483.CrossRefGoogle Scholar
  72. Tikkanen, R., & Ross, M. (2003). Technological tearoom trade: Characteristics of Swedish men visiting gay Internet chat rooms. AIDS Education and Prevention, 15, 122–132.PubMedCrossRefGoogle Scholar
  73. Van Beneden, C. A, O’Brien, K., Modesitt, S., Yusem, S., Rose, A., & Fleming, D. (2002). Sexual behaviors in an urban bathhouse 15 years into the HIV epidemic. Journal of Acquired Immune Deficiency Syndrome, 30, 522–526.Google Scholar
  74. Van de Ven, P., Prestage, G., Crawford, J., Gulich, A., & Kippax, S. (2000). Sexual behavior increases is associated with HIV optimism among HIV negative and HIV positive gay men in Sydney over the Four-year period to February 2000. AIDS, 14, 2951–2953.PubMedCrossRefGoogle Scholar
  75. Weatherburn, P., Hickson, F., & Reid, D. (2003). Gay men’s use of the Internet and other settings where HIV prevention occurs. London: Sigma Research.Google Scholar
  76. Woods, W. J., Binson, D. K., Mayne, T. J., Gore, L.R., & Rebchook, G.M. (2000). HIV/sexually transmitted disease education and prevention in US bathhouse and sex club environments. AIDS, 14, 625–626.PubMedCrossRefGoogle Scholar
  77. Woods, W. J., Binson, D. K., Mayne, T. J., Gore, L. R., & Rebchook, G. M. (2001). Facilities and HIV prevention in bathhouse and sex club environments. Journal of Sex Research, 38, 68–74.CrossRefGoogle Scholar
  78. Youle, M., & Wainberg, M. A. (2003). Could chemoprophylaxis be used as an HIV prevention strategy while we wait for an effective vaccine? AIDS, 17, 937–938.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Christian Grov
    • 1
    • 2
  • Jeffrey T. Parsons
    • 1
    • 3
    • 4
  • David S. Bimbi
    • 1
    • 4
  1. 1.Center for HIV/AIDS Educational Studies and Training (CHEST)New YorkUSA
  2. 2.Department of SociologyGraduate Center of the City University of New York (CUNY)New YorkUSA
  3. 3.Department of PsychologyHunter College of the City University of New YorkNew YorkUSA
  4. 4.Department of PsychologyGraduate Center of the City University of New York (CUNY)New YorkUSA

Personalised recommendations