Effects of structural intervention on increasing condom availability and reducing risky sexual behaviours in gay bathhouse attendees

Abstract

The study purpose was to evaluate the effectiveness of a structural intervention in reducing unprotected sexual behaviours, increasing condom accessibility and their relationship to the prevalence of HIV infection and sexually transmitted infections (STIs) in gay bathhouse attendees. A quasi-experimental study with a non-equivalent control group for comparison was conducted at nine gay bathhouses in Taiwan from 2004 to 2006. A structural intervention designed to increase condom distribution and accessibility inside the bathhouses was implemented at one bathhouse in each city. Bathhouse attendees were invited to complete a questionnaire and to be screened for HIV infection and STIs. Of 632 study participants, 270 were surveyed six months after the intervention was conducted. At the time of follow-up after controlling for baseline data, patrons attending bathhouses for which intervention was performed were more likely to report accessing condoms inside bathhouses than those attending control bathhouses (92.6% versus 81.3%, P = 0.016), and condoms were more likely to be available at the reception desk of the bathhouse entrance (87.5% in intervention bathhouses versus 69.4% in control, P = 0.047). In a multivariate analysis adjusted for age, access to condoms inside bathhouses (adjusted odds ratio (AOR): 4.35; 95% confidence interval (CI): 1.48-12.78) and attendance at bathhouses with intervention (AOR: 2.07; 95% CI: 1.07-3.97) were independently associated with consistent condom use during anal intercourse. There were no significant differences in the prevalences of HIV infection and STIs at the six-month follow-up. Bathhouses with structural intervention were associated with consistent condom use during anal intercourse among bathhouse patrons. Our findings highlight the importance of extension of condom distribution inside the bathhouses to increase condom use among bathhouse patrons.

Event-Specific Risk Factors Predicting Episodes of Unprotected Anal Intercourse with Male Nonregular Partners among Men Who Have Sex with Men Using Case-Crossover Study Design

“…Of equal importance is the protective effect of condom availability, which corroborates literature discriminating consistent versus inconsistent condom users among MSM [6, 27]. The results of the current study have practical implications, in that it seems useful to place and to distribute condoms at the venue where anal sex commonly takes place.…”

Sex Parties among Young Gay, Bisexual, and Other Men Who Have Sex with Men in New York City: Attendance and Behavior

“…Additionally, recent research has demonstrated the effectiveness of pilot programs that have sought to partner commercial sex environments with groups offering HIV testing and education onsite. 60,61 Results from these studies have shown that interventions have been efficacious in reducing the spread of HIV and other STIs in such environments and these services are currently being replicated. 61 Consequently, only a small percentage of our overall sample indicated sex party attendance and data on specific acts of sexual behavior during sex parties was not collected during this study.…”

Condom Negotiations among Female Sex Workers in the Philippines: Environmental Influences

“…Other studies have found that having access to condoms was associated with safer sex practices among women who worked in bars in Tijuana, Mexico [37] and decreased unprotected sex among bathhouse patrons in Taiwan [38]. Studies underscore the importance of a supportive social environment for FSWs in China and India, such as a venue's condom availability, managerial support of condom availability, and clinic visitations [39], [40].…”