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Commercial sex venues: a closer look at their impact on the syphilis and HIV epidemics among men who have sex with men
  1. G Aynalem1,
  2. L Smith1,
  3. C Bemis1,
  4. M Taylor1,2,
  5. K Hawkins1,
  6. P Kerndt1
  1. 1Los Angeles County STD Program, Department of Health Services, Los Angeles, CA, USA
  2. 2Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, GA, USA
  1. Correspondence to:
 Getahun Aynalem
 MD, MPH, Los Angeles County STD Program, 2615 South Grand Ave, Room 500, Los Angeles, CA 90007, USA; gaynalem{at}


Objective: To provide insight into the role of commercial sex venues in the spread of syphilis and HIV among men who have sex with men (MSM).

Study: A cross sectional study of 1351 MSM who were diagnosed with early syphilis who did and did not encounter sexual partners at commercial sex venues.

Results: Overall, 26% MSM diagnosed with syphilis had sexual encounters at commercial sex venues. Of these, 74% were HIV positive, 94% reported anonymous sex, and 66% did not use a condom. Compared to those who did not have a sexual encounter at these venues, they were twice as likely to be HIV positive (OR = 1.91, 95% CI 1.36 to 2.68), six times more likely to have anonymous sex (OR = 6.18, 95% CI 3.37 to 11.32), twice as likely not to use condom (OR = 2.02, 95% CI 1.71 to 2.38), and twice as likely to use non-injecting drugs (OR = 1.65, 95% CI 1.21 to 2.37).

Conclusions: MSM diagnosed with syphilis who frequent commercial sex venues are engaging in high risk behaviours for syphilis and HIV transmission and acquisition. Thus commercial sex venues are one of the focal points of syphilis and HIV transmission and acquisition.

  • FTA-ABS, fluorescent treponemal antibody absorption
  • HAART, highly active antiretroviral therapy
  • MSM, men who have sex with men
  • STDs, sexually transmitted diseases
  • TPPA, Treponema pallidum particle agglutination
  • commercial sex venues
  • syphilis
  • HIV
  • risk behaviours
  • men who have sex with men

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  • Source of funding: none.

  • Conflict of interest: none.