Gay and bisexual men's experiences of bathhouse culture and sex: ‘looking for love in all the wrong places’

Abstract

The aim of this study was to describe gay and bisexual men's experiences of bathhouses and their perceptions of HIV risk associated with sex in this context. Face‐to‐face, semi‐structured interviews were conducted with a purposive sample of gay and bisexual men—14 HIV‐positive and 9 HIV‐negative—who reported ever frequenting a bathhouse. The sample was selected from the Polaris HIV Seroconversion Study, a longitudinal open cohort study of documented recent seroconverters and HIV‐negative controls in Ontario, Canada. Interview transcripts were analysed using a narrative approach. Four major themes were identified concerning views of gay bathhouse culture and environments; moral conceptions of self and others at a bathhouse; identity management at a bathhouse; and psychosocial functions of gay bathhouses. HIV transmission is a salient component of bathhouse culture; therefore, bathhouses are critical environments for the promotion of safer sex activities among gay and bisexual men.

Acknowledgements

We express our gratitude to the men who participated in this study. In addition, we would like to thank the physicians, clinics and community organizations that assist with recruitment and data collection. We also wish to acknowledge our current and past funders: the Canadian Institutes of Health Research, Health Canada (funding reference # HHP‐44976); National Health Research and Development Program, Health Canada (grant #6606‐06‐1998/2550001 C); AIDS Prevention and Community Action Program, Health Canada (grant #6962‐15‐1998‐1840004); AIDS Bureau, Ontario Ministry of Health and Long‐Term Care; the GlaxoSmithKline Positive Action Program, and the AIDS Program Committee of the Ontario Ministry of Health.

Notes

Dennis J. Haubrich is Professor in the School of Social Work, Faculty of Community Services, Ryerson University, Ontario, Canada. Ted Myers is Director of the HIV Social, Behavioural and Epidemiological Studies Unit, Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Liviana Calzavara is Deputy Director of the HIV Social, Behavioural and Epidemiological Studies Unit, Department of Public Health Sciences, Faculty of Medicine, University of Toronto. Karen Ryder and Wendy Medved are also at the HIV Social, Behavioural and Epidemiological Studies Unit. All correspondence should be addressed to: Dennis J. Haubrich, School of Social Work, Faculty of Community Services, Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3 Canada; e‐mail: [email protected]

• Résumé

• L'objectif de cette étude était de décrire les expériences de sauna chez les hommes gay et bisexuels, et leurs perceptions des risques liés au VIH dans ce contexte. Des entretiens semi‐structurés en face à face ont été menés auprès d'un échantillon calculé d'hommes gay et bisexuels – 14 séropositifs et 9 séronégatifs – qui déclaraient avoir déjà été dans un sauna. L'échantillon était sélectionné à partir de la Polaris HIV Seroconversion Study, une étude de cohorte ouverte portant sur des cas documentés de séroconversions récentes et sur un groupe contrôle de personnes séronégatives en Ontario, Canada. Les transcriptions des entretiens ont été analysées grâce à une approche narrative. Quatre thèmes majeurs ont été identifiés, relatifs: à la culture et aux environnements des saunas gay; aux conceptions morales de soi et des autres dans un sauna; à la gestion de l'identité dans un sauna; aux fonctions psychosociales des saunas gay. La transmission du VIH est un élément majeur de la culture des saunas; par conséquent, les saunas constituent des environnements critiques pour la promotion des activités sexuelles protégées chez les hommes gay et bisexuals.

• Resumen

• La finalidad de este estudio era describir las experiencias de hombres homosexuales y bisexuales en las casas de baños y conocer cuáles eran sus percepciones en este contexto sobre el riesgo de contagio del virus del sida a través de las relaciones sexuales. Se llevaron a cabo entrevistas cara a cara y semiestructuradas con una muestra deliberada de hombres homosexuales y bisexuales – 14 VIH positivos y 9 VIH negativos – que afirmaron haber visitado alguna vez una casa de baños. La muestra fue seleccionada del Polaris VIH Seroconversion Study en Ontario, Canadá, un estudio longitudinal y abierto con seroconvertidores recientemente documentados y VIH negativos como grupo de control. Se analizaron transcripciones de entrevistas usando un enfoque narrativo. Se identificaron cuatro temas principales: qué opinaban de la cultura y los ambientes en las casas de baños homosexuales; las concepciones morales de uno mismo y de los demás en las casas de baño; el control de identidad en las casas de baño; y las funciones psicosociales de las casas de baños para homosexuales. La transmisión de VIH es un componente dominante en la cultura de casas de baños; por consiguiente, los baños son ambientes decisivos para el fomento de actividades sexuales más seguras entre hombres homosexuales y bisexuales.

Additional information

Notes on contributors

Wendy Medved

Dennis J. Haubrich is Professor in the School of Social Work, Faculty of Community Services, Ryerson University, Ontario, Canada. Ted Myers is Director of the HIV Social, Behavioural and Epidemiological Studies Unit, Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Liviana Calzavara is Deputy Director of the HIV Social, Behavioural and Epidemiological Studies Unit, Department of Public Health Sciences, Faculty of Medicine, University of Toronto. Karen Ryder and Wendy Medved are also at the HIV Social, Behavioural and Epidemiological Studies Unit. All correspondence should be addressed to: Dennis J. Haubrich, School of Social Work, Faculty of Community Services, Ryerson University, 350 Victoria Street, Toronto, Ontario, M5B 2K3 Canada; e‐mail: [email protected]