title: Gay saunas and the risks of HIV and syphilis transmissions in China--results of a meta-analysis.
abstract: BACKGROUND
  Previous studies suggest the risk of human immunodeficiency virus (HIV) transmission among men who have sex with men (MSM) is associated with characteristics of venues. However, very few studies have systematically compared HIV/sexually transmitted disease (STD) prevalence among MSM according to key venue type for sourcing sex partners.
  
  
  OBJECTIVE
  The aim of this study was to investigate the associations between HIV/syphilis prevalence and the types of venues, namely saunas, parks, gay bars, and the Internet, which are mostly used for sourcing male sex partners by MSM in China.
  
  
  METHODS
  Meta-analyses using fixed-effect and random-effect methods were conducted. Secondary data were obtained from 10 concurrent surveys conducted in 10 cities basing on a common protocol. Pairwise comparisons (e.g., "saunas" vs. "parks") were made.
  
  
  METHODS
  Odds ratios (OR) for HIV/syphilis infection in relations to venue type for partner sourcing.
  
  
  RESULTS
  The distribution of the most commonly used source to recruit male sex partner was 59.32% (Internet), 18.47% (gay bars), 14.18% (gay saunas), and 8.02% (parks). The median prevalence of HIV/syphilis was 10.49% and 19.38% (gay saunas), 2.12% and 16.25% (parks), 6.06% and 15.45% (Internet), and 4.41% and 11.90% (gay bars). We found significant between-group differences when comparing "sauna" against "Internet" (HIV: OR= 2.27, 95% confidence interval [CI] = 1.65-3.12; syphilis: OR = 1.61, 95% CI= 1.07-2.41), "sauna" against "bars" (HIV: OR= 1.65, 95% CI= 1.14-2.39; syphilis: OR= 1.35, 95% CI= 1.02-1.78), and "parks" against "Internet" (syphilis: OR= 1.55, 95% CI= 1.12-2.15) as the main source to recruit male sex partners. Other pairwise comparisons were not statistically significant.
  
  
  CONCLUSIONS
  The results of this study suggest that those sourcing partners mainly from gay saunas have higher prevalence of HIV/syphilis when compared with those doing so via the Internet or gay bars. Venue based (sauna-based) interventions using socio-ecological approaches are greatly warranted in order to reduce HIV and syphilis prevalence among MSM in China.
authors: Centre for Health Behaviors Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. jlau@cuhk.edu.hk
authors: Joseph T F
authors: JT
authors: Lau
authors: Jin-Kou
authors: JK
authors: Zhao
authors: Xiao-Bing
authors: XB
authors: Wu
authors: Jing
authors: J
authors: Gu
authors: Chun
authors: C
authors: Hao
mesh_terms: D002681:China / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D018451:Homosexuality, Male; D006801:Humans; D020407:Internet; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D011633:Public Facilities; D012309:Risk-Taking; D029002:Steam Bath; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000453:epidemiology / Q000635:transmission*