Prevalence of human immunodeficiency virus and sexually transmitted infections and risky sexual behaviors among men visiting gay bathhouses in Taiwan

OBJECTIVES: This study aimed to investigate the prevalence of human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) and predictors of risky sexual behaviors among men visiting gay bathhouses. STUDY DESIGN: A cross-sectional study was conducted at 8 gay bathhouses in Taiwan. Bathhouse attendees were invited to complete a questionnaire and to be screened for HIV/STIs. RESULTS: Of 451 men recruited for the study, 339 (75%) completed the questionnaire and were screened for HIV/STIs. The study indicated that seroprevalence rates of anti-HIV-1 antibody, specific Treponema pallidum antibodies detected by hemagglutination assay, surface antigen of hepatitis B virus, IgG antibodies for hepatitis A virus, antibody for hepatitis C virus, and indirect hemagglutination antibody for Entamoeba histolytica (serum titer ≥1:128) were 8%, 18%, 16%, 38%, 3%, and 6%, respectively. Prevalence rates for chlamydial and gonococcal infections reflected by nucleic acid amplification tests in urine samples were 7% and 4%, respectively. Irregular use of condoms during oral sex, condom inaccessibility at bathhouses, unprotected sex at public venues, no prior HIV test, and 5 or more visits to bathhouses every month were independently associated with unprotected anal intercourse. CONCLUSION: Men attending gay bathhouses report engaging in unsafe sex practices and are at substantial risk of acquisition of HIV/STIs. These findings highlight the need for more comprehensive prevention efforts at gay bathhouses.