Table of Contents
ISRN Infectious Diseases
Volume 2014, Article ID 934839, 9 pages
Research Article

Contexts of HIV-Related Risk Behaviors among Male Customers at Asian Massage Parlors in San Francisco

1Public Health Institute, 555 12th Street, Suite 290, Oakland, CA 94607, USA
2San Francisco State University, San Francisco, CA, USA
3Walden University, Minneapolis, MN, USA

Received 7 November 2013; Accepted 14 January 2014; Published 4 March 2014

Academic Editors: B. Best and F. Uribe-Salas

Copyright © 2014 Tooru Nemoto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Based on focus groups for male customers who frequented Asian massage parlors in San Francisco, the present study described their sexual and drug use behaviors and attitudes toward practicing safe sex with Asian masseuses. A pervasive view among patrons was that they could engage in sex with masseuses without using a condom if they offered extra money. Their sexual behaviors with Asian masseuses were influenced by perceptions about vulnerability toward HIV/STIs, substance use behaviors, and masseuses’ initiation of condom use, which was often governed by unspoken rules at parlors. Customers perceived massage parlors as being a safe place compared with street sex venues. Some customers sought emotional attachment with Asian masseuses and expressed stereotypical views toward them as being docile and submissive. Culturally appropriate HIV/STI prevention programs (e.g., communication about and practicing 100% condom use) are needed to target both customers and Asian masseuses at multiple levels (individual, owner/manager, work environment, and community levels). Also, customers’ and masseuses’ perceptions toward relationships at massage parlors and power dynamics need further investigation to promote safe work environments and 100% condom use at massage parlors.