However, given the contours of the early HIV epidemic in most urban areas ( Turner, Miller, & Moses, 1989), bathhouses became associated with risk for HIV. Prior to the epidemic bathhouses had long been considered much safer places, in terms of risks of assault or robbery, than the many other types of public venues where men met for sex, ( Berube, 2003 Weinberg & Williams, 1975). In response to the AIDS epidemic of the early 1980s, sexual behavior in gay bathhouses drew significant attention from health officials, politicians and journalists ( Bayer, 1989 Berube, 2003 Disman, 2003). AIDS dramatically changed these venues in form and function. Thus, in the period just prior to AIDS bathhouses were reputable for their absolute lack of monitoring. These gay spaces provided a place of exploration for the gay male sexuality and sociality that was safely removed from the repressive gaze of heteronormative society ( Halperin, 1995 Rubin, 2004 Tattleman, 1997 Winkler, 2006). Unlike earlier periods when sexual behavior needed to be discreet, gay bathhouses emerged as significant institutions supporting the burgeoning gay culture ( Berube, 2003). In the period between the onset of gay liberation (traditionally marked at about 1969) but before onset of the AIDS epidemic among gay men (1981), gay bathhouses and sex clubs began to multiply dramatically ( Woods, Tracy, & Binson, 2003). The responsibility of managers to monitor the sexual behavior of patrons in gay bathhouses has a circuitous history. This paper explores each approach as described by club managers, staff, and patrons to understand the potential effectiveness of monitoring as an HIV prevention intervention.
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An analysis found that monitoring was influenced by the kinds of space available for sex, suggesting three approaches to monitoring: 1) monitoring all sex in clubs that only had public areas where men had sex 2) monitoring some sex in clubs with private rooms for sex and 3) no monitoring of sex, regardless of the kinds of space for sex. Yet, monitoring has received little evaluation.Ä«etween 20, we conducted qualitative interviews with venue managers, staff and patrons in New York City, Los Angeles, and the San Francisco Bay Area.
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Perhaps none of these are as intrusive to the venue's environment as what is called "monitoring," which involves staff, during every shift, repeatedly walking throughout the public areas of a bathhouse to check on patrons' sexual behavior. Many HIV prevention interventions have been launched in gay bathhouses and sex clubs since the onset of the AIDS epidemic, such as condom distribution and HIV testing.