Physical and social influences of sex venue behavior: An ecological psychology approach to studying HIV risk among sexual minority men

Commercial and public sex venues are known to provide men who have sex with other men (MSM) with access to sexual encounters that may increase their likelihood of acquiring or transmitting HIV and other sexually transmitted infections (STIs). Most venue-based research has not addressed environmental affordances that may facilitate on-site behavior and potentially contribute to HIV/STI risk. The current study assessed perceived physical and social elements of sex venues and the association with condomless anal sex (CAS) using an ecological psychology approach. In 2008, 204 MSM completed an online survey about pastmonth venue attendance, sexual behavior, and perceptions of sex venue environments. Most (68.1%) attended at least one venue during the previous month; 24% reported CAS during attendance. Men who reported CAS in a gym or video booth perceived greater availability of private spaces than attendees not reporting CAS (both p < .05). Participants who reported CAS in a public bathroom estimated a significantly lower percentage of other venue patrons' condom use compared to attendees who did not report CAS (M = 7.4% vs. M = 27.7%, p < .01). And men who reported CAS during any recent venue visit had a greater preference for group sex and for dimly-lit venue spaces than attendees who did not report CAS (both p < .05). Venue-based interventions should consider preferences and perceptions of venue users, and work with owners and policymakers to develop structural solutions that address HIV/STI risk.