Background:
Non-occupational post-exposure prophylaxis (PEP) may be effective in preventing HIV transmission and acquisition among men at high risk for infection.

Objective:
To describe the knowledge of and reported use of pre and post-exposure prophylaxis for HIV among men who have sex with men (MSM) attending two New York City bathhouses.

Method:
An ongoing enhanced HIV screening project in two New York City bathhouses began in February, 2006. MSM visiting the bathhouses are offered rapid HIV testing as well as PCR testing for acute HIV infection. Participants also undergo risk reduction counseling and a standardized face-to-face interview regarding sexual and drug using behaviors.

Result:
As of March 21, 2006, 43 MSM have participated and been tested for HIV. HIV seroprevalence was 7% (95% CI: 1.5%-19.1%). The median age of participants was 37 years (range: 22-76); 17% were African-American, 28% Latino, and 35% White. 7 (16.3%) reported currently being married to a female. 23 (53.5%) reported they would not likely have been tested for HIV in the following month if testing was not offered at the bathhouse. The median number of sexual partners in the past 90 days was 10 (range: 0-80) and 80% reported bathhouses as the primary place to meet sex partners. The median partners/hr spent at the bathhouse was 0.33 (range: 0-2). Only 12% had ever heard of PEP, and the 1 person reporting using PEP was a medical provider. None of the participants reported use of pre-exposure prophylaxis.

Conclusion:
This high risk population most likely to benefit from PEP, was largely unaware of its existence. Outreach regarding PEP to men attending commercial sex venues (CSVs) such as bathhouses may be a productive primary and secondary prevention strategy.


Implications:
CSVs may be a unique health care site for interaction with high risk individuals. Screening for STIs in the population is warranted.