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If you want to introduce drastic and unpopular changes, a crisis (real or invented) is a handy excuse. What 9/11 was to the U.S. Constitution via the Patriot Act, a controversy in New York over increasing HIV infections may be to the city's gay bathhouses.

The latest saga started last year with a press release issued (coincidentally on September 11) by the New York City Department of Health and Mental Hygiene, which sounded the alarm over HIV infection rates. The data suggested that new infections among men under 30 who had sex with men had jumped 33 percent since 2001.

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The city commissioned a report to consider what to do, and the report was leaked to gay journalists with a conservative bent on bathhouse sex. They seized on the report's suggestions of shutting New York's few remaining such establishments.

As presented by Duncan Osborne in New York's Gay City News, the leaked report outlined four possible options for dealing with bathhouses and sex clubs:

· maintain the status quo

· shut the clubs immediately

· step up efforts to close the baths and clubs eventually

· increase regulation, including visual inspections of the sexual activity by the health board to make sure people are having safe sex.

The statistics driving the discussion show an increase in the number of new infections from 374 in 2001 to 500 in 2007. While the actual increase in numbers is small -- only about 125 new infections over 2001's numbers in a city of millions -- the percentage increase is notable. The biggest increase came with among the young and the black. For blacks under 30, the increase was twice as high as that among whites in the same age range. And among males aged 13 to 19, there was a doubling of infections.

But are baths and sex clubs the source of the problem? And would shutting or constraining them be a solution?

Besides keeping things as they are, New York seems to be contemplating a policy like San Francisco's, where bathhouses with private rooms have not been permitted since the onset of the AIDS crisis. Instead, the city only allows "sex clubs" with open areas where all activity can be directly monitored by club staff and members of the health department. People caught having unprotected sex can be barred permanently.

"It costs about ten bucks to get into my favorite club, and the babysitting is free," says Dave, a San Francisco sex club regular.

But the two more extreme options raised in the report worry some activists.

"It would be a horrendous mistake to close the bathhouses," says Dr. Demetre Daskalakis, who has spearheaded efforts to reintroduce HIV testing and education in the couple of remaining bathhouses in Manhattan. "We're reaching men who cannot be reached otherwise, and closing the baths would just drive them underground."

Other cities have used sex venues as opportunities for public health education and intervention.

"Here we work together with the health department to educate and test for HIV," says Peter Bochove, co-owner of Spa Excess in Toronto and president of the local STD clinic. He added that he has a co-operative relationship with health authorities, with everyone understanding that unsafe sex happens because of what people are thinking and not because of the location they are in. "There are a million places where people can have sex. We wouldn't think of closing the baths for that reason here."

During a 2006 meningitis outbreak, the clubs set up vaccination clinics right inside the bathhouses themselves, which helped bring the situation under control.

In New York, where there are only a few bathhouses and a minimum of education efforts inside, the rate of new HIV infections among men who get tested is currently running four percent. In Ontario, where bathhouses are as common as 7-11's, their rate is only one percent.

"What we really see happening in New York is an exercise in self-oppression," says Richard Hudler, an American living in Canada and a member of the Toronto-based Sex Laws Committee. "These HIV statistics have been used as a thinly disguised excuse to push forward a conservative moral agenda."

But no decision has been made yet. The city health department tells The Guide that while they are considering their options, no change in policy is planned just now.

Author Profile:  Joseph Couture

Joseph Couture is a journalist based on London, Ontario.