Background: Identifying places with current HIV transmission may provide key targets for HIV control strategies.
Objectives: To determine the prevalence of HIV at community venues; the likelihood of current venue-based HIV transmission by comparing current high HIV-risk heterosexual and parenteral behaviors by HIV (vs. no HIV) venues; and features of venues associated with current high HIV-risk behaviors.
Methods: A venue-based, cross-sectional study of 18-35 year-olds was conducted in one urban area from 2008-2009. Participants reported self and sex partner behaviors. Venue informants reported on whether the venue was a sex market (i.e exchange sex for money or drugs) or a drug market (i.e. drugs bought or sold). Venue-level associations between HIV (vs. no HIV) venues and high HIV-risk heterosexual (i.e. past 12 months sex with IDU or HIV + or use of crack) and parenteral behaviors (i.e. past 6 months IDU or needle-sharing) were statistically tested.
Results: Using a systematic venue-identification approach, 87 venues were selected. Among 1,611 participants, 60 HIV cases were identified. 43% venues had at least one HIV case. Among these venues, 68% had one HIV case and 32% had > 2. At HIV (vs. no HIV) venues high HIV-risk heterosexual sexual (92% vs. 57%, P<0.001) and parenteral behaviors (68% vs. 37%, P<0.01) were significantly greater. An increased, not statistically significant, percentage of HIV (vs. no HIV) venues were drug markets (65% vs. 44%, P=0.05), sex markets (46% vs. 35%, P=0.30) and drug/sex markets (40% vs. 23%, P=0.09). In multivariate analyses, HIV (vs. no HIV) venues had significantly greater odds of high HIV-risk heterosexual behaviors (AOR 5.60; 95% CI 1.36, 23.01).
Conclusions: This study highlights the importance of place-based approaches in identifying HIV-risk venues.
Implications for Programs, Policy, and Research: Venues may be key targets for HIV transmission control, i.e. control screening and treatment of HIV positives and secondary transmission prevention.