Archives of Sexual Behavior

, Volume 47, Issue 7, pp 2027–2034 | Cite as

Gay Circuit Parties in Barcelona and Their Impact on Gonorrhea Incidence

  • Juan M. Leyva-Moral
  • Maria Feijoo-CidEmail author
  • David Moriña
  • Joan A. Caylà
  • Maider Arando
  • Martí Vall
  • María Jesús Barbera
  • Pere Armengol
  • Alvaro Vives
  • Gemma Martin-Ezquerra
  • Mercè Alsina
  • Patricia García Olalla
Original Paper


This study explored the role of circuit parties on the incidence of gonorrhea among men who have sex with men (MSM) in Barcelona (Spain). Specifically, it aimed to detect cyclic peaks in the number of reported diagnoses of gonorrhea after gay circuit parties. We analyzed monthly cases of gonorrhea reported from January 2007 through December 2016 after the main annual gay circuit parties in Barcelona. We used the integer autoregressive model for time series with discrete values. The performance of the model was tested in heterosexual men and women, in whom the circuit parties could be expected to have no impact. A sensitivity analysis was conducted, changing post-event diagnosis windows to 1 week later/1 week before. In the study period, a total of 4182 of gonorrhea cases were detected, of which 74.8% (n = 2181) occurred in men who identified themselves as MSM. The average annual increase in gonorrhea cases reported among MSM was 32.57%. In an independent analysis of each gay circuit party, cases increased significantly in two of them. The results were also similar for same-sex practices among men only. On controlling for the increasing trend over the study period and the seasonal effect, an average of 1.16 gonorrhea cases in MSM (95% CI: 0.68, 1.64) were attributable to the celebration of one of the gay circuit parties considered. During the expected outbreak, an average of 13 gonorrhea cases were detected and between 5 and 13% were attributable to one of the circuit parties. In view of these findings, participants should consider seeking advice from their healthcare provider and practice safer sex using condoms to prevent sexually transmitted infections. Local public health services should be reinforced to ensure care for participants during and after gay circuit parties. More research is needed to design and implement preventive programs.


Gay circuit parties Gonorrhea STD HIV screening MSM Sexual orientation 



We thank Juanse Hernández from gTt-VIH and MariJo Vázquez for their insightful comments to previous versions of the manuscript. This work was partially supported by grants from the Instituto de Salud Carlos III-ISCIII (Spanish Government) cofunded by FEDER funds/European Regional Development Fund (ERDF)—a way to build Europe (References: RD12/0036/0056, PI11/02090 and PI16/01254) and from the Agència de Gestió d’Ajuts Universitaris i de Recerca (2014SGR756) and RecerCaixa 2015 (2015ACUP00129).

Funding statements

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Supplementary material

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  1. ACN. (2016). Arranca el Pride Barcelona 2016 con especial atención a la transexualidad y mayor previsión de afluencia. La Vanguardia. Retrieved January 15, 2018, from
  2. Agencia de Salut Publica de Barcelona. (2011). Morbiditat per malalties de declaració obligatória a barcelona ciutat. Estadístiques de Salut; n.23. Retrieved June 15, 2017, from
  3. Agencia de Salut Publica de Barcelona. (2016). La salut a Barcelona 2015. Retrieved June 15, 2017, from
  4. Ahmed, A.-K., Weatherburn, P., Reid, D., Hickson, F., Torres-Rueda, S., Steinberg, P., & Bourne, A. (2016). Social norms related to combining drugs and sex (“chemsex”) among gay men in South London. International Journal of Drug Policy, 38, 29–35. Scholar
  5. Área de Vigilancia de VIH y Comportamientos de Riesgo. Vigilancia Epidemiológica del VIH y sida en España. (2015). Sistema de Información sobre Nuevos Diagnósticos de VIH y Registro Nacional de Casos de Sida. Retrieved January 15, 2018, from
  6. Boletín Oficial del Estado. (2015). Orden SSI/445/2015, de 9 de marzo, por la que se modifican los anexos I, II y III del Real Decreto 2210/1995, de 28 de diciembre, por el que se crea la Red Nacional de Vigilancia Epidemiológica, relativos a la lista de enfermedades de declaración obliga. Retrieved June 15, 2017, from
  7. Bowring, A., van Gemert, C., Vongsaiya, K., Hughes, C., Sihavong, A., Phimphachanh, C., … Hellard, M. (2014). Identifying risk: A comparison of risk between heterosexual-identifying bisexual men and other bisexual men in Vientiane, Laos. AIDS Education and Prevention, 26(2), 109–121.CrossRefPubMedGoogle Scholar
  8. Carnicer-Pont, D., Smithson, A., Fina-Homar, E., Bastida, M. T., & Gonococcus Antimicrobial Resistance Surveillance Working Group. (2012). First cases of Neisseria gonorrhoeae resistant to ceftriaxone in Catalonia, Spain, May 2011. Enfermedades Infecciosas Y Microbiología Clínica, 30(4), 218–219. Scholar
  9. Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT). (2016). Vigilància epidemiològica sentinella de les infeccions de transmissió sexual a Catalunya a partir del sistema de notificació de malalties de declaració obligatòria i del sistema de notificació microbiològica. Informe anual 2015. Badalona. Retrieved January 15, 2018, from
  10. Cheung, D. H., Lim, S. H., Guadamuz, T. E., Koe, S., & Wei, C. (2014). The potential role of circuit parties in the spread of HIV among men who have sex with men in Asia: A call for targeted prevention. Archives of Sexual Behavior, 44(2), 389–397. Scholar
  11. Coleman, T. A., Bauer, G. R., Pugh, D., Aykroyd, G., Powell, L., & Newman, R. (2017). Sexual orientation disclosure in primary care settings by gay, bisexual, and other men who have sex with men in a Canadian City. LGBT Health, 4(1), 42–54. Scholar
  12. Colfax, G. N., Mansergh, G., Guzman, R., Vittinghoff, E., Marks, G., Rader, M., & Buchbinder, S. (2001). Drug use and sexual risk behavior among gay and bisexual men who attend circuit parties: a venue-based comparison. Journal of Acquired Immune Deficiency Syndromes, 28(4), 373–379. Scholar
  13. Decret 203/2015. Diari Oficial de la Generalitat de Catalunya, Catalunya, España, 17 septiembre de 2015.Google Scholar
  14. EFE/BARCELONA. (2016). Barcelona, capital gay mundial hasta el 14 de agosto. La Vanguardia. Retrieved January 15, 2018, from
  15. Fleming, D. T., & Wasserheit, J. N. (1999). From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sexually Transmitted Infections, 75(1), 3–17. Retrieved January 15, 2018, from
  16. Folch, C., Casabona, J., Muñoz, R., González, V., & Zaragoza, K. (2010). Increase in the prevalence of HIV and in associated risk behaviors in men who have sex with men: 12 years of behavioral surveillance surveys in Catalonia (Spain). Gaceta Sanitaria, 24(1), 40–46. Scholar
  17. Grov, C., Parsons, J. T., & Bimbi, D. S. (2010). Sexual compulsivity and sexual risk in gay and bisexual men. Archives of Sexual Behavior, 39(4), 940–949. Scholar
  18. Hafner, L. M., & Timms, P. (2013). Chlamydia. In L. R. Stanberry & S. N. Rosenthal (Eds.), Sexually transmitted diseases: Vaccines, prevention and control (2nd ed., pp. 369–410). London: Academic Press.CrossRefGoogle Scholar
  19. Hesse, M., & Tutenges, S. (2012). Music and substance preferences among festival attendants. Drugs and Alcohol Today, 12(2), 82–88. Scholar
  20. Kinyua, J., Negreira, N., Miserez, B., Causanilles, A., Emke, E., Gremeaux, L., … van Nuijs, A. L. (2016). Qualitative screening of new psychoactive substances in pooled urine samples from Belgium and United Kingdom. Science of the Total Environment, 573(15), 1527–1535. Scholar
  21. Kurtz, S. P. (2005). Post-circuit blues: Motivations and consequences of crystal meth use among gay men in Miami. AIDS and Behavior, 9(1), 63–72. Scholar
  22. Lee, S. J., Galanter, M., Dermatis, H., & McDowell, D. (2003). Circuit parties and patterns of drug use in a subset of gay men. Journal of Addictive Diseases, 22(4), 47–60. Scholar
  23. Malek, R., Mitchell, H., Furegato, M., Simms, I., Mohammed, H., Nardone, A., & Hughes, G. (2015). Contribution of transmission in HIV-positive men who have sex with men to evolving epidemics of sexually transmitted infections in England: An analysis using multiple data sources, 2009–2013. Eurosurveillance, 20(15), 7–15. Scholar
  24. Mansergh, G., Colfax, G. N., Marks, G., Rader, M., Guzman, R., & Buchbinder, S. (2001). The circuit party men’s health survey: Findings and implications for gay and bisexual men. American Journal of Public Health, 91(6), 953–958. Scholar
  25. Martí-Pastor, M., García de Olalla, P., Barberá, M.-J., Manzardo, C., Ocaña, I., Knobel, H., … Villar, J. (2015). Epidemiology of infections by HIV, Syphilis, Gonorrhea and Lymphogranuloma Venereum in Barcelona City: A population-based incidence study. BMC Public Health, 15, 1015. Scholar
  26. Mattison, A. M., Ross, M. W., Wolfson, T., Franklin, D., Grant, I., Atkinson, J. H., … Wolfson, T. (2001). Circuit party attendance, club drug use, and unsafe sex in gay men. Journal of Substance Abuse, 13(1–2), 119–126. Scholar
  27. Moriña, D., Puig, P., Ríos, J., Vilella, A., & Trilla, A. (2011). A statistical model for hospital admissions caused by seasonal diseases. Statistics in Medicine, 30(26), 3125–3136. Scholar
  28. O’Byrne, P., & Holmes, D. (2011). Drug use as boundary play: A qualitative exploration of gay circuit parties. Substance Use and Misuse, 46, 1510–1522. Scholar
  29. Palamar, J. J., Acosta, P., Ompad, D. C., & Cleland, C. M. (2017). Self-reported ecstasy/MDMA/“Molly” use in a sample of nightclub and dance festival attendees in New York City. Substance Use and Misuse, 52(1), 82–91. Scholar
  30. Pappas, M. K., & Halkitis, P. N. (2011). Sexual risk taking and club drug use across three age cohorts of HIV-positive gay and bisexual men in New York City. AIDS Care, 23(11), 1410–1416. Scholar
  31. Pathela, P., Hajat, A., Schillinger, J., Blank, S., Sell, R., & Mostarshari, F. (2006). Discordance between sexual behavior and self-reported sexual identity: A population-based survey of New York City men. Annals of Internal Medicine, 145, 416–442.CrossRefPubMedGoogle Scholar
  32. Paz-Bailey, G., Meyers, A., Blank, S., Brown, J., Rubin, S., Braxton, J., … Markowitz, L. E. (2004). A case-control study of syphilis among men who have sex with men in New York City association with HIV infection. Sexually Transmitted Diseases, 31(10), 581–587. Scholar
  33. Prat Forga, J. M. (2014). Nuevos planteamientos y nuevas motivaciones en la elección de destinos de turismo cultural-urbano homosexual: El festival circuit de Barcelona. Cuadernos de Turismo, 0(33), 311–334.Google Scholar
  34. Prat Forga, J. M. (2015). Las motivaciones de los turistas LGBT en la elección de la ciudad de Barcelona. Documents d’Anàlisi Geogràfica, 61(3), 601–621. Scholar
  35. Reisen, C. A., Zea, M. C., Bianchi, F. T., Poppen, P. J., Shedlin, M. G., & Penha, M. M. (2010). Latino gay and bisexual men’s relationships with non-gay-identified men who have sex with men. Journal of Homosexuality, 57(8), 1004–1021. Scholar
  36. Serra-Pladevall, J., Barberá, M. J., Rodriguez, S., Bartolomé-Comas, R., Roig, G., Juvé, R., & Andreu, A. (2016). Neisseria gonorrhoeae antimicrobial susceptibility in Barcelona: penA, ponA, mtrR, and porB mutations and NG-MAST sequence types associated with decreased susceptibility to cephalosporins. European Journal of Clinical Microbiology and Infectious Diseases, 35(9), 1549–1556. Scholar
  37. Serra-Pladevall, J., Barberá-Gracia, M. J., Roig-Carbajosa, G., Juvé-Saumell, R., Gonzalez-Lopez, J. J., Bartolomé-Comas, R., & Andreu-Domingo, A. (2013). Neisseria gonorrhoeae: Resistencias antimicrobianas y estudio de la dinámica poblacional. Situación en 2011 en Barcelona. Enfermedades Infecciosas Y Microbiología Clínica, 31(9), 579–583. Scholar
  38. Sewell, J., Lampe, F. C., Cambiano, V., Speakman, A., Phillips, A. N., Stuart, D., … Clarke, A. (2017). Poly drug use, chemsex drug use, and associations with sexual risk behaviour in HIV-negative men who have sex with men attending sexual health clinics. International Journal of Drug Policy, 43, 33–43. Scholar
  39. Sexton, J., Garnett, G., & Røttingen, J.-A. (2005). Metaanalysis and metaregression in interpreting study variability in the impact of sexually transmitted diseases on susceptibility to HIV infection. Sexually Transmitted Diseases, 32(6), 351–357. Retrieved January 15, 2018, from
  40. Solomon, M. M., Mayer, K. H., Glidden, D. V., Liu, A. Y., McMahan, V. M., Guanira, J. V., … Grant, R. M. (2014). Syphilis predicts HIV incidence among men and transgender women who have sex with men in a preexposure prophylaxis trial. Clinical Infectious Diseases, 59(7), 1020–1026. Scholar
  41. Theodore, P. S., Durg, R. E., & Antoni, M. H. (2014). Drug use and sexual risk among gay and bisexual men who frequent party venues. AIDS and Behavior, 18(11), 2178–2186. Scholar
  42. Vázquez, F., Otero, L., Ordás, J., Junquera, M. L., & Varela, J. A. (2004). Actualización en infecciones de transmisión sexual: epidemiología, diagnóstico y tratamiento. Enfermedades Infecciosas Y Microbiología Clínica, 22(7), 392–411. Scholar
  43. Vos, T., Barber, R. M., Bell, B., Bertozzi-Villa, A., Biryukov, S., Bolliger, I., … Duan, L. (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 386(9995), 743–800. Scholar
  44. Ward, H., & Rönn, M. (2010). Contribution of sexually transmitted infections to the sexual transmission of HIV. Current Opinion in HIV and AIDS, 5(4), 305–310. Scholar
  45. WHO. (2016). Sexually transmitted infections (STIs) [Fact sheet]. Geneva: Author. Retrieved from
  46. Wong, W., Chaw, J. K., Kent, C. K., & Klausner, J. D. (2005). Risk factors for early syphilis among gay and bisexual men seen in an STD clinic: San Francisco, 2002–2003. Sexually Transmitted Diseases, 32(7), 458–463. Scholar
  47. World Medical Association. (2013). Declaration of Helsinki-Ethical Principles for Medical Research Involving Human Subjects.Google Scholar
  48. Zenilman, J. M., & Deal, C. D. (2013). Gonorrhea: Epidemiology, Control and Prevention. In L. R. Stanberry & S. L. Rosenthal (Eds.), Sexually transmitted diseases: Vaccines, prevention and control (2nd ed., pp. 411–426). London: Academic Press.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Juan M. Leyva-Moral
    • 1
  • Maria Feijoo-Cid
    • 1
    Email author
  • David Moriña
    • 2
  • Joan A. Caylà
    • 3
    • 4
  • Maider Arando
    • 5
  • Martí Vall
    • 5
  • María Jesús Barbera
    • 5
  • Pere Armengol
    • 5
  • Alvaro Vives
    • 6
  • Gemma Martin-Ezquerra
    • 7
  • Mercè Alsina
    • 8
  • Patricia García Olalla
    • 3
    • 4
  1. 1.Department of Nursing, Faculty of MedicineUniversitat Autònoma de BarcelonaBarcelonaSpain
  2. 2.Unit of Infections and Cancer - Information and Interventions (UNIC-I&I)Catalan Institute of Oncology (ICO)-IDIBELLL’Hospitalet de LlobregatSpain
  3. 3.Epidemiology ServicePublic Health Agency of BarcelonaBarcelonaSpain
  4. 4.CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain
  5. 5.Sexually Transmitted Infection Unit-Vall HebronHospital de la Vall d’HebronBarcelonaSpain
  6. 6.Sexually Transmitted Infection UnitFundació PuigvertBarcelonaSpain
  7. 7.Department of DermatologyHospital del MarBarcelonaSpain
  8. 8.Department of DermatologyHospital ClínicBarcelonaSpain

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