Commercial sex venues: a closer look at their impact on the syphilis and HIV epidemics among men who have sex with men.
OBJECTIVE
To provide insight into the role of commercial sex venues in the spread of syphilis and HIV among men who have sex with men (MSM).


METHODS
A cross sectional study of 1351 MSM who were diagnosed with early syphilis who did and did not encounter sexual partners at commercial sex venues.


RESULTS
Overall, 26% MSM diagnosed with syphilis had sexual encounters at commercial sex venues. Of these, 74% were HIV positive, 94% reported anonymous sex, and 66% did not use a condom. Compared to those who did not have a sexual encounter at these venues, they were twice as likely to be HIV positive (OR = 1.91, 95% CI 1.36 to 2.68), six times more likely to have anonymous sex (OR = 6.18, 95% CI 3.37 to 11.32), twice as likely not to use condom (OR = 2.02, 95% CI 1.71 to 2.38), and twice as likely to use non-injecting drugs (OR = 1.65, 95% CI 1.21 to 2.37).


CONCLUSIONS
MSM diagnosed with syphilis who frequent commercial sex venues are engaging in high risk behaviours for syphilis and HIV transmission and acquisition. Thus commercial sex venues are one of the focal points of syphilis and HIV transmission and acquisition.
Aynalem
G
G
MPH, Los Angeles County STD Program, 2615 South Grand Ave, Room 500, Los Angeles, CA 90007, USA. gaynalem@dhs.co.la.ca.us
Smith
L
L
Bemis
C
C
Taylor
M
M
Hawkins
K
K
Kerndt
P
P
D000328:Adult; D000368:Aged; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D011477:Sex Work / Q000706:statistics & numerical data*; D012747:Sexual Partners; D013587:Syphilis / Q000453:epidemiology* / Q000635:transmission