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Introduction Places are an important determinant of risk for STI transmission. We sought to identify places that are critical for targeted STI control activities. The objective of this study was to determine whether sex partner meeting places characterised by drug markets, sex markets and separately, drug and/or sex markets were more likely to have core transmitters as compared to other sex partner meeting places in one urban setting. Methods In 2008–2009, heterosexual sex partner places or venues were identified in Baltimore, MD using a venue-based study approach. Core transmitters were defined by their sexual network connectivity and disease status, i.e. self-report of sexual concurrency and diagnosis of a current bacterial STI. Results 1,334 participants aged 18–35 years were enrolled at 85 venues. 39 core transmitters were identified and 31% of venues had at least one core transmitter. In final age- and gender-adjusted models, core transmitters were significantly more likely to be identified at drug markets (OR 1.37; 95% CI 1.23, 1.53), sex markets (OR 1.27; 95% CI 1.14. 1.41) and drug and/or sex markets (OR 1.49; 95% CI 1.32, 1.68). Conclusions This study identified key characteristics of venues, such as drug and sex market activity, which may be important in identifying places for the targeted control of STI transmission. The Centre for Child and Community Health Research (CCHR) and the Baltimore City Health Department were funded for this work by the Centres for Disease Control and Prevention and the NIH. No pharmaceutical grants were received in the development of this study.

Background HIV transmission has been associated with specific populations in specific places, i.e. places where drug and sexual networks overlap consistently. Canvassing places or venues where people congregate has been shown to be an effective means of identifying sexually transmitted infection cases for public health control and surveillance purposes. The objectives of this study were to identify and characterise heterosexual sex partner meeting venues in one U.S. urban area according to according to the presence or absence of HIV cases. Methods Eighty-seven potential high-HIV-risk heterosexual sex partner meeting venues were identified using a three-phase methodology. Subsequently, a venue-based, cross-sectional study of sexually active 18–35 year olds was conducted in Baltimore, Maryland from October 2008 through December 2009. Results 1,594 participants were enrolled at 87 venues. Fifty-nine HIV cases were identified yielding an overall HIV prevalence of 3.7% and a mean venue prevalence of 3.6% (range = 0% to 25%). One or more cases of HIV was identified at 42% (n = 37) of venues (i.e. HIV positive venues). In bivariate analysis, commercial sex work (OR: 1.04; 95% CI: 1.01, 1.08), high HIV-risk sexual partnering (OR: 1.11; 95% CI: 1.03, 1.20), recent parenteral risk behaviour (OR: 1.05; 95% CI: 1.01, 1.10) and drug market activity (OR: 2.67; 95% CI: 1.09, 6.52) were reported significantly more frequently at HIV positive versus HIV negative venues. In final age-adjusted models, HIV positive venues had 10% more high HIV-risk sexual partnering (OR: 1:10; 95% CI: 1.01, 1.19) and more than twice as much drug market activity (OR: 2.59; 95% CI: 1.04, 6.46) compared to HIV negative venues. Sex market activity was not significantly associated with venue HIV status. Conclusions This study highlights characteristics of venues, such as drug markets, that may be important in identifying places which are more likely to have active HIV transmission.