HIV risk behaviour among men who have sex with men in public sex environments: an ecological evaluation

Men who have sex with men (MSM) in public sex environments (PSE) may be at high risk for HIV/AIDS. The majority of research on HIV risk behaviour amon g MSM has been conducted in open access venues more likely to be linked to networks that openly endorse preventive messages and safer sex norms. This study investigated risk practices among MSM in a PSE in order to develop ef fective prevention intervention strategies. Three outreach workers with pre vious MSM prevention experience trained in ethnographic and fieldwork obser vation techniques provided direct observation data. Seventy-seven observati ons, each lasting a minimum of two hours, were conducted over a five-month period at three city public parks. Of 614 men observed, over 250 exhibited activities and behaviours related to, or potentially related, to HIV-risk r elevant sexual behaviour. Direct sexual contact between two or more men was observed 19 times, while men entering or leaving a sex area of the park wa s observed 66 times. Outreach workers were able to interact directly with 7 2 MSM, primarily discussing safer sex strategies. Sexual encounters occurre d in more open areas of the PSE with partners migrating to secluded areas f or intense and sexual interactions. Future prevention interventions will ne ed to be tailored, and targeted, to specific sexual exchange access points in PSE.