Designing an HIV Counseling and Testing Program for Bathhouses The Seattle Experience with Strategies to Improve Acceptability

• Published in: Journal of homosexuality Vol. 44; no. 3-4; pp. 203 - 220
• Main Authors: Spielberg, Freya, Branson, Bernard M., Goldbaum, Gary M., Kurth, Ann, Wood, Robert W.
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis Group 01.01.2003; Taylor & Francis LLC
• Subjects: Acquired Immune Deficiency Syndrome; Acquired Immunodeficiency Syndrome - prevention & control; Acquired Immunodeficiency Syndrome - psychology; Adult; AIDS; AIDS Serodiagnosis; Anonymous Testing; Bathhouse; Bathhouses; Counseling; Counselling; Counselling services; Diagnostic tests; Gays & lesbians; Health Planning; HIV; HIV counseling and testing; HIV prevention; Homosexuality; Homosexuality, Male; Homosexuals; Human immunodeficiency virus; Human relations; Humans; Interpersonal communication; Legislation; Leisure; Male; Males; Medical screening; Men; Patient Acceptance of Health Care; Personal relationships; Prevention; Preventive programmes; Psychology; Public Facilities; Public Space; Seattle; Seattle, Washington; Sex venues; Sexuality; Sexually transmitted diseases; Staff; Testing; Tests; Therapy; U.S.A; USA; Washington; Washington
• ISSN: 0091-8369; 1540-3602
• DOI: 10.1300/J082v44n03_09

Bathhouses are important venues for providing HIV counseling and testing to high-risk men who have sex with men (MSM), yet relatively few bathhouses routinely provide this service, and few data are available to guide program design. We examine numerous logistic considerations that had been identified in the HIV Alternative Testing Strategies study and that influenced the initiation, effectiveness, and maintenance of HIV testing programs in bathhouses for MSM. Key programmatic considerations in the design of a bathhouse HIV counseling and testing program included building alliances with community agencies, hiring and training staff, developing techniques for offering testing, and providing options for counseling, testing, and disclosure of results. The design included ways to provide client support and follow-up for partner notification and treatment counseling and to maintain relationships with bathhouse management for support of prevention activities. Early detection of HIV infection and HIV prevention can be achieved for some high-risk MSM through an accessible and acceptable HIV counseling and testing program in bathhouses. Keys to success include establishing community prevention collaborations between bathhouse personnel and testing agencies, ensuring that testing staff are supported in their work, and offering anonymous rapid HIV testing. Use of FDA approved, new rapid tests that do not require venipuncture, centrifugation, or laboratory oversight will further decrease barriers to testing and facilitate implementation of bathhouse testing programs in other communities.