Background:
As a basis for prevention efforts, it is essential to understand the “sexual marketplace” or venues used to identify sexual partnership of those at risk of acquisition and/or transmission of STDs.

Objective:
To examine the difference in “sexual marketplace” preference among the different age, racial/ethnic and sexual orientation groups reported with early syphilis.

Method:
The different venues used for sexual encounter by age, race/ethnicity and sexual orientation were assessed. The odds of initiating sexual contact through the different sexual marketplaces were calculated for each study group.

Result:
Over all, the frequency of “sexual marketplaces” among 2315 early syphilis cases were: 37.8% bars and clubs, 21.3% the Internet, 18.6% bathhouses, 10.9% streets, 3.9% parks, 3.9% motels, and 1.1% dancehalls. Whites are more likely to initiate sexual encounters through the Internet (OR=4.6, 95% CI 3.6-5.7), at bathhouses (OR=1.8, 95% CI 1.5-2.3), and less likely at parks (OR=0.5, 95% CI 0.3-0.8), on the streets (OR=0.3, 95% CI 0.2-0.5), and in motels (OR=0.6, 95% CI 0.4-0.9) than African Americans and Hispanics. MSM are more likely to initiate sexual encounters at bars and clubs (OR=3.9, 95% CI 3.0-5.1), through the Internet (OR=85.1, 95% CI 21.2-342.5), and less likely on the streets OR=0.4, 95% CI 0.3-0.5), and in motels (OR=0.4, 95% CI 0.2-0.6) than heterosexuals. Those who are more than 30 years of age are more likely to initiate sexual encounters at bathhouses, through the Internet and less likely on the streets and dancehalls (p<0.05).

Conclusion:
The “sexual marketplace” to initiate sexual contacts of patients with early syphilis varies based on their age, race/ethnicity and sexual orientation.

Implications:
Findings from this study highlight the need for targeted HIV and STDs prevention interventions tailored to the difference in age, race/ethnicity and sexual orientation at the different sex venues.