title: Implementation of HIV testing at 2 New York City bathhouses: from pilot to clinical service.
abstract: BACKGROUND
  Commercial sex venues (e.g., bathhouses) that cater to men who have sex with men (MSM) continue to function in most urban areas. These venues present a challenge to developing strategies to prevent the spread of the human immunodeficiency virus (HIV), but they also provide opportunities for interventions to reduce the risk and rate of disease transmission. Several cities in the United States have developed programs that offer HIV testing in these venues. Similar programs have not existed before in New York City.
  
  
  METHODS
  A pilot HIV testing program was implemented at 2 New York City bathhouses. Testing included rapid HIV testing, the use of the serologic testing algorithm for recent HIV seroconversion, and pooled plasma HIV viral load to detect and date incident and acute HIV infections. In addition to HIV tests, behavioral and demographic data were collected from 493 presumed HIV-negative participants.
  
  
  RESULTS
  The pilot program recruited MSM who were at high risk for HIV infection. Of the 493 men tested, 20 (4%) were found to be positive for HIV, and 8 (40%) of these 20 men demonstrated evidence of acute or recent HIV infection. The program tested men often not tested in more traditional medical settings. Significant disparities were demonstrated in the testing habits of MSM who reported having sex with women and had not disclosed same-sex activities to their caregivers.
  
  
  CONCLUSIONS
  Bathhouse-based testing for HIV infection can be implemented in New York City and would include a population of MSM who are at high risk for HIV infection. Because of the high rate of recent HIV infection, expanded testing in these venues may be a good strategy to reduce the forward transmission of HIV in this highly sexually active population.
authors.affiliation: Division of Infectious Diseases and Immunology, New York University Langone Medical Center, New York, New York 10016, USA. demetre.daskalakis@med.nyu.edu
authors.forename: Demetre
authors.initials: D
authors.lastname: Daskalakis
authors.forename: Richard
authors.initials: R
authors.lastname: Silvera
authors.forename: Kyle
authors.initials: K
authors.lastname: Bernstein
authors.forename: Dylan
authors.initials: D
authors.lastname: Stein
authors.forename: Robert
authors.initials: R
authors.lastname: Hagerty
authors.forename: Richard
authors.initials: R
authors.lastname: Hutt
authors.forename: Alith
authors.initials: A
authors.lastname: Maillard
authors.forename: William
authors.initials: W
authors.lastname: Borkowsky
authors.forename: Judith
authors.initials: J
authors.lastname: Aberg
authors.forename: Fred
authors.initials: F
authors.lastname: Valentine
authors.forename: Michael
authors.initials: M
authors.lastname: Marmor
mesh_terms: D015492:AIDS Serodiagnosis; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D011633:Public Facilities; D012307:Risk Factors; D019562:Viral Load; D055815:Young Adult