Gay Bathhouse Study: 10% of Patrons Admit to Highest AIDS-Risk Sex

A controversial study of the clientele and culture of gay bathhouses in Los Angeles County has found that a small but potentially significant minority of patrons acknowledge engaging in sexual practices known to pose the highest risk of transmitting the AIDS virus.

Those men tend to be younger, less affluent and less educated than most of the largely white, well-educated, middle-class crowd that frequents the bathhouses, the study found. And they are more likely to have had at least five male sexual partners in the previous month.

“Since almost all men claimed familiarity with the AIDS prevention information available in the bathhouses . . . a clear inconsistency existed for some men between their AIDS knowledge and their actual sexual behavior,” states the study, published this week.

UCLA Research Team

The authors, a team of researchers at the UCLA School of Public Health who did the study on a grant from the Los Angeles County Bathhouse Owners’ Assn., contend that their findings illustrate the importance of using the bathhouses as a forum for education about AIDS prevention.

But critics, some of whom charge that the study is biased, contend that the findings bolster their argument that the bathhouses should be closed--a position that has been endorsed by the county’s Commission on AIDS and members of the county Department of Health Services.

Last week, county Dist. Atty. Ira Reiner filed suit against three bathhouses, alleging that the owners violated a county ban on anal and oral sex. Reiner’s move, aimed at closing the bathhouses, capped a two-month undercover investigation by his office and county health officials.

12 Open in County

The UCLA study, published in the Journal of Sex Research, is an attempt to quantify scientifically the activities conducted in gay bathhouses. Twelve bathhouses remain open in the county, catering to an estimated 2,000 to 4,000 customers each week.

The researchers found that 10% of the 807 men interviewed in the summer of 1986 acknowledged engaging in unprotected anal intercourse--a practice the researchers chose to emphasize as posing the highest risk of spreading the human immuno-deficiency virus.

Another 61% of those interviewed reported having participated in sexual practices said by the researchers and other experts to pose varying, but generally lesser, degrees of risk. Those included anal intercourse with a condom and protected and unprotected oral sex.

The remaining percentage reported no sexual contact or only kissing and masturbation.

Nine percent of the men interviewed reported regular sexual contact with women, posing a risk of spreading the virus to heterosexuals, the researchers said.

Nearly all the men interviewed said they were familiar with the AIDS-prevention literature available in the bathhouses, the study found. About half said that information played a major role in their understanding of AIDS prevention.

The researchers found those last statistics significant.

“This is a prime opportunity to educate men, some of whom are practicing sex in an unsafe way,” said Dr. Gary Richwald, an assistant professor at the UCLA School of Public Health and the principal author of the study.

While Richwald said he was “absolutely appalled” by some of the risks men were taking, he said he believed “our educational efforts need to be redoubled. I think there is not one shred of evidence that prohibition has any impact on behavior change.”

Critics of the bathhouses, however, drew a very different conclusion.

Dr. Caswell Evans, director of public health programs for the county, focused on the 10% of bathhouse users who reported practicing unsafe sex. Saying “10% is no longer acceptable,” Evans said he believes the study justifies the county’s efforts to close the bathhouses.

Gary Fowler, chairman of the county AIDS commission’s task force on bathhouses, also challenged the objectivity of the study. He said it was “ludicrous” for UCLA to put its name on a study “that is supposed to be unbiased” but is financed by bathhouse owners.

“You need to judge the study on its merits,” countered Richwald, noting that all research receives funding from one source or another. He also added, “The real answer is that this is not a clean bill of health for the bathhouses.”

Richwald said he believes that the statistics in the study remain relevant despite the time that has elapsed since the interviews. If anything, he said, increased awareness of AIDS might have reduced the frequency of high-risk activities.

The researchers approached 1,636 men leaving seven bathhouses over a six-week period. About half agreed to fill out a three-page questionnaire, which included 52 questions covering such issues as age, race, income, sexual behavior and reasons for attending bathhouses.

The researchers noted that the selection of participants was not entirely random, since bathhouse patrons could choose not to participate. But Richwald said most declined because they were in a hurry, not because they wanted to hide sexual activities.