Bay Area Reporter - July 13, 2001
Liz Highleyman

The "Circuit Party Men's Health Survey" was conducted by Dr. Susan Buchbinder and colleagues from the University of California at San Francisco. Circuit parties - multi-day gatherings held in major cities across the country - draw tens of thousands of gay and bisexual men annually. The researchers surveyed 295 gay and bi San Francisco men who had attended a circuit event in the previous year.

Circuit parties have been stereotyped as occasions for rampant drug use and unsafe sex, and some of the survey's results tend to support this image. A large majority of men reported using psychoactive drugs at their most recent circuit party. A quarter said they had experienced a drug "overuse" event in the past year in which they had passed out, required medical attention, or were unable to care for themselves. However, of these incidents, only 28 percent actually occurred at a circuit event. The most commonly overused drugs were gamma hydroxy butyrate (GHB), gamma butyrolactone (GBL), ketamine (Special K), and alcohol. Most men used more than one drug (including alcohol). Interestingly, while ecstasy was widely used, it was not commonly associated with overuse problems. Most men said that they used drugs on the dance floor or in a bathroom.

Two-thirds of the men reported engaging in oral or anal sex over the course of a circuit party weekend. About a quarter had unprotected anal sex (38 percent receptive and 65 percent insertive) with a person of opposite or unknown HIV serostatus; the remainder had protected sex or sex with someone of the same serostatus. A regression analysis indicated that the more drugs a man used, the more likely he was to have unprotected anal sex.

Given the prevalence of drug use and sex, some AIDS activists maintain that circuit parties present an excellent opportunity for health education. Although only a minority of adverse drug-related incidents occur at circuit events themselves, the parties may prove a good venue for reaching men who also do drugs elsewhere. The researchers concluded, "The likelihood of transmission of HIV and other sexually transmitted diseases among party attendees and secondary partners becomes a real public health concern."

They recommend that party organizers and agencies that benefit from circuit fundraising events should work with "public health and prevention professionals as well as community members" to develop "comprehensive and effective interventions designed to reduce risk behavior and promote health among gay and bisexual men who attend circuit parties."

Pap tests

Utilization of health care by lesbian and bisexual women has not been well studied, but it is commonly believed that lesbians are less likely than heterosexual women to receive regular preventive care. In part, this may be because women who have sex exclusively with other women do not require birth control, the factor that drives many women who have sex with men to their gynecologists each year. Pap tests are an important part of regular preventive care for women. This test detects abnormal cells that may be precursors to cervical cancer. Certain types of human papillomavirus (HPV) are known to increase the risk of cervical cancer, and HPV DNA testing is increasingly common.

Jeanne Marrazzo and colleagues studied 248 women in Seattle who had had sex with another woman in the previous year. The researchers collected medical and sexual histories, and well as cervical and vaginal specimens for Pap and DNA testing. Most of the women in the study were white, well-educated, and under age 40. A large proportion had had sex with men as well as women (80 percent in their lifetimes and 23 percent in the past year).

Results showed that lesbian women who had never had sex with men were significantly more likely than women who had sex with both women and men to have never had a gynecological examination, to have received their first Pap test at an older age, to have had fewer Pap tests during the past five years, and to wait longer between Pap tests. Almost all the women thought they should receive a Pap test every one to two years, but over a third gave a reason for not doing so. The most common reasons were lack of health insurance, not knowing where to get a test, negative experiences during a previous test, and the belief that women who did not have sex with men did not need Pap tests. A few women said they had been told by a healthcare provider that they did not need the test if they did not have sex with men.

HPV DNA was found in the samples from 13 percent of the women; 74 percent of these showed a cancer-causing type of HPV. The researchers concluded, "Because data indicate that HPV is sexually transmitted between female partners and may not require previous or recent sex with men," women who have sex with women may have an "increased risk for delayed detection of cervical cancer through less frequent or no Pap test screening." Among the other articles in the special theme issue are an editorial on the health crisis among transgender people by Leslie Feinberg, a report from the San Francisco Department of Public Health's Transgender Health Project, an article on violence experienced by queer adolescents, and a report by UCSF's Rafael Diaz on how homophobia, racism, and poverty impact the mental health of gay and bisexual Latino men.
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