Male patrons at gay bathhouses who were tested for the virus that causes AIDS were infected at a rate twice that of men tested in public clinics or community-based agencies, a new Los Angeles County study found.
In response, health officials suggested that an increase in such voluntary testing and in safe-sex education at the bathhouses would discourage risky behavior there.
"It's a great place to do more intervention and prevention work," said Trista Bingham, director of the study and an epidemiologist with the county Department of Health Services. The bathhouse setting is an especially good place to test and educate men who might not otherwise identify themselves as gay or bisexual or agree to be tested in a more public setting, she added.
The results of the study were announced this week, as the federal Centers for Disease Control and Prevention reported an unsettling 7.1% increase in HIV infections among homosexual and bisexual men in 2002, compared with the previous year.
The infection rate rose for the third year in a row after declining for several years. The CDC report included data from 25 states, though California and New York were not among them.
National experts said the increases in HIV infections are a dangerous sign that a younger generation has become more complacent because of medical advances that allow many HIV-infected people to live longer without progressing to AIDS.
The Los Angeles County study found that, of 916 men tested at two Los Angeles bathhouses between May 2001 and December 2002, 102 of them, or 11%, were diagnosed with HIV. By comparison, 5.5% of men who took the test at public clinics and community-based agencies in Los Angeles in 2000 were HIV-positive.
In addition, fewer than half of the bathhouse customers who tested positive followed up by seeking their test results, according to the study.
Bingham said the data did not show why bathhouse customers might have a higher infection rate. But she said the health department recognizes the baths as places where some men engage in unprotected sex.
She said that such behavior might change if infected men find out they are HIV-positive.
Scott Campbell, who runs three bathhouses in Los Angeles County, including one involved in the testing program, said the higher rate was cause for concern and that he hoped more men would take advantage of the counseling, free condoms and free HIV testing his clubs offer.
