Rampant drug use and risky sex are commonplace at circuit parties (popular weekend-long, gay-themed dance parties), putting party-goers at substantial risk for HIV infection, according to a study of gay and bisexual men in San Francisco, CA who attended these events. The study was published in the June 2001 edition of the American Journal of Public Health.

Researchers from the CDC's Division of HIV/AIDS Prevention surveyed 295 gay or bisexual men age 18 and older who attended at least one circuit party in the previous year. Some respondents were recruited outside of gay venues (such as nightclubs, gyms, a gay pride event, sex clubs and other businesses). Others responded to flyers that advertised the study, or were referred by participants already enrolled. Almost 60 percent were between the ages of 25 and 34, 97 percent identified as gay, 79 percent had a bachelor's degree or attended graduate school and 34 percent earned salaries of US$60,000 or more.

The study found that 95 percent of the men used at least one psychoactive drug during the last circuit party they attended; 61 percent used three or more drugs. Ecstasy was the most popular (75 percent had taken it), ketamine the second most popular (58 percent) and alcohol the third (56 percent). Around 7 percent of the men said they passed out, needed medical assistance or could not take care of themselves as a result of using drugs.

In addition, 29 percent of respondents reported having multiple sex partners (with whom they had oral or anal sex) during the event. Among these men, 24 percent reported unprotected anal sex with a partner whose HIV serostatus was different from theirs or unknown to them. Almost half of all respondents reported having a primary partner (defined as someone they lived with or seen a lot and to whom they felt a special emotional commitment), but among these men, 27 percent reported multiple sex partners (oral or anal) during the festivities. Overall, 17 percent of respondents said their most recent HIV test was positive and 83 percent said it was negative.

"As a whole, these findings suggest that a substantial drug culture permeates the circuit party environment, a drug culture that is distinct from broader communities of gay and bisexual men," the study authors wrote. In addition, drug use was found to increase sexual risk behavior, so much so that the study authors called the likelihood of HIV and STD transmission among party attendees "a real public health concern."

On an encouraging note, making condoms and safer sex and drug abuse information available to party-goers may help reduce their risk-taking behavior, according to the study. The researchers attended a circuit party where condoms and pamphlets were displayed. Over 60 percent of attendees noticed the condoms, and around one-third of these men helped themselves to some. In the case of the pamphlets, around one-third of the men took notice, of whom around 28 percent read the safer sex info and 53 percent read the drug abuse info.

"Condom visibility and accessibility are important factors in condom use," the study authors wrote. And in the case of drugs, "attendees need to be knowledgeable about multi-drug interactions and mixing psychoactive drugs with medical treatments [such as antiretrovirals]."

The researchers urged public health officials to reach out to circuit party attendees, and for organizers of these parties to implement risk-reduction strategies.