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Rising Rate of HIV Infection Renews Bathhouse Debate

L.A. County officials are considering tougher safe-sex rules for gay establishments. But some activists fear patrons' civil rights may be infringed.

March 23, 2004|Sharon Bernstein | Times Staff Writer

Amid growing concerns about HIV infection among gay men, public health officials in Los Angeles County are once again facing the politically charged question of how to regulate gay bathhouses and sex clubs.

County health officials are considering tougher enforcement of existing laws that require bathhouse patrons to use condoms. They also are debating whether to impose the safe-sex rules on other types of gay sex clubs and require all to offer condoms, information on safe sex, and on-site testing for HIV and other sexually transmitted diseases. Facilities that don't comply could be shut down.

The review was triggered by a recent Los Angeles County study that showed newly diagnosed HIV infections to be seven times higher among bathhouse patrons than among others who were tested for HIV. The Board of Supervisors ordered the health department to develop a proposal for updating the regulations by May 15.

The county's epidemiologists have just begun to work out the details, but the process has already stirred up a debate that to some is reminiscent of one that raged during the early days of the AIDS crisis.

As in the early 1980s, public health officials and many AIDS activists worry that without intervention, the number of HIV cases will spiral out of control.

Now, as then, bathhouse owners and some gay rights activists argue that to close or restrict the bathhouses and sex clubs would infringe on the civil rights of patrons and business owners.

"When you start regulating whether or not people can have safe sex, maybe one day you'll regulate whether people of the same sex can have sex with each other at all," said lobbyist Steve Afriat, who was hired by several bathhouse owners to fight tougher regulation of the establishments.

"So there's a resistance to having regulations on what the clubs can and cannot allow," he said.

But those who favor more restrictions on bathhouses and sex clubs accuse the owners of trying to stir up old passions, at the expense of men who might become infected.

Twenty years ago, bathhouses were a flash point in the arguments over how to contain the emerging epidemic. In some cities men would line up around the block at the most popular spots for a night of typically unprotected, often anonymous sex in whirlpool baths, saunas and small private rooms.

To many in the gay community the baths were important symbols of their sexual liberation, but to epidemiologists the establishments were ground zero for the spread of HIV among gay men.

Those who advocated closing the bathhouses -- or even regulating them -- were booed or shouted down in public meetings. When San Francisco ordered its bathhouses closed in 1984, angry activists demonstrated at City Hall, and the city's public health director received so many death threats that he wore a bulletproof vest for four months.

Now, with several national and local indicators showing that gay men are at increasing risk of HIV infection after years of declines, epidemiologists are again concerned about the role of bathhouses in the spread of infection.

Policy in Los Angeles

Unlike San Francisco, officials in Los Angeles County let its bathhouses stay open, passing instead an ordinance requiring owners to provide condoms and instruct patrons in safe-sex practices, as well as making the use of condoms mandatory during sexual activity.

A wholesale shutdown of the 11 gay bathhouses and sex clubs known to be operating in Los Angeles County is not likely, said Dr. Jonathan Fielding, the county's director of public health, because research indicates that patrons will simply seek partners at other venues. Already, he said, the Internet seems poised to surpass bathhouses and sex clubs as a way to find partners or attend sex parties where multiple partners are available.

But the bathhouses and sex clubs do play an important role in transmission of the disease, and those in charge of safeguarding the public health need to confront that, Fielding said.

The best approach, he said, would be to draft new rules with the cooperation of the club owners. That way, there is a greater chance that educational messages about safe sex -- perhaps forgotten as a new generation has come of age since the epidemic began -- will get through to some of the men who are putting themselves at risk for HIV.

But once new regulations are in place, "I would not hesitate to close down a place that is recalcitrant," Fielding said.

Among the few gay leaders actively calling for more regulation of the clubs is Michael Weinstein, president of the AIDS Healthcare Foundation and a frequent critic of county health policy.

"The debate always seems to counterpoise civil liberties to public health," Weinstein said. "But if you are earning money in a commercial establishment from creating a sex environment, then you should be required to make that environment as safe as possible, or you shouldn't be allowed to operate."

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