Saturday, January 2, 2010

Using Marginal Cost Curves in a Bathhouse to Combat STDs

Using Marginal Cost Curves in a Bathhouse to Combat STDs (WARNING)

WARNING: if you have a problem with reading about gay culture and bathhouses, do not read this entry.



Con Cuidado


Here it is.

Since New Year’s Eve, I have been eating out and drinking in a ridiculous manner. Over the past 40 hours I have been to:


Brew & View,


Starbucks (three times),

Argo Tea,


Joy’s Noodle,

Melrose Café, and

the new gelato place on Melrose and Broadway.

With the exception of Melrose Café, I was in a party of two or more, and I noticed that there was a central strand in all my social gatherings. Instead of talking about the New Year, or what we hope to achieve, the issue of “Steamworks” came up three times. For those not in the know, Steamworks is a “bathhouse” in Chicago. For those innocent of lascivious matters, a bathhouse is a complex where individuals go to have sex. In the context of Steamworks, it is a gay bathhouse. I now know why I have such few friends. In order to be popular I need to stop talking about Charles River Bridge v. Warren Bridge and write epistles about bathhouses.

As I stated, I had three conversations about Steamworks. In the first, a friend (“Jacob”) told me that he had to breakup with a “boyfriend” because the beau was HIV positive. Jacob mentioned that in hindsight it was not particularly surprising because he found out that the beau often met five or more men per visit.

The second discussion about Steamworks came out in passing when I asked “Emmett” about his frenemy “Jasper”. Emmett told me that even when Jasper was in a relationship, he still frequented Steamworks. In fact Jasper’s family was so appalled by his behavior, his mother actually went into the complex and asked the office to page his son.

The third discussion was with “Bella” whom told me that her brother was recently diagnosed with Hepatitis A. Both Bella and her brother believed that he contracted the disease from his many visits to Steamworks.

Now Dear Reader, I would like to dispel several notions that may be going through your head:

I. In none of these situations did I bring the issues of Steamworks or even sex (more the lack of) up;

II. My friends tend to be god-fearing types in stable relationships, and

III. I do not go to such places because I am

a. Spending all my money on food and drink;

b. Getting fat because of food and drink;

c. Have lost all interest in carnal desires and replaced it … with my love for quinoa and coffee.

That being said, the issue of condoms was brought up in discussions with Jacob and Bella. In both instances, they both confirmed that the infected party did not use a condom.

I am not a homosexual anthropologist, but I know that during the AIDS outbreak, gay culture went underground. Sexual norms included the use of condoms. But times change. With the acceptance of alternative lifestyles, people started to come out at an earlier age. Men having sex with each other was no longer taboo, it became a sort of amusement for the ladies of Sex & The City; a reoccurring chapter at the Oscars. Equally important are the good people at Gilead Sciences (Nasdaq: GILD) whom developed increasingly effective medication and treatments to combat various STDs including, HIV and Hepatitis A. As my friend, “Dr. Edward” said, “The life expectancy of a [HIV] positive individual is … 20 years. It is not the death penalty it once was.” This confluence of events led to the turning away of the bleak times of the AIDS outbreak, and to a new sense of carpe diem with gay men. We don’t have to worry about being safe because the STIGMA is not as sharp; the medication, not as invasive.

Now I do not know if Jacob’s boyfriend, or Bella’s brother engaged in such mental calculus, but between 2004-2008, the number of people newly infected with Hepatitis A, Syphilis, or Chlamydia rose (I could not determine HIV infection rates because the website breaks out its reporting by months and I got a bit lazy with my abacus). Inference does not lead to causation, but the inference is pretty strong. People increasingly do not use condoms, and they are getting infected.

An alarmist would argue “Close the fucking place down.” In fact this was the argument that a date, a dean of a prestigious graduate school presented. If Chicago can present evidence that Steamworks leads to greater incidents of HIV, then the city should use its police powers to close it down. Now this is completely constitutionally valid. In fact, until the dawn of this new decade, I use to hew to this orthodoxy. But now, as mercurial as my beliefs have become, I think there should be bathhouses, but there should also be incentives for the use of condoms.

I am not going into the logistics of it, but I presume that when two people engage in carnal activity, they prefer not using a condom. This preference appears to transcend sexual orientations. For example, many of my female friends use birth control in the form of prescription drugs rather than having their male partners wrap it up. Now I know there are some benefits in using pills; for example, one friend states it makes her skin better – but holding all things equal, a condom would be much less invasive. Hence, everyone has some sort of marginal cost (MC) in using a condom; less enjoyable sex. But that cost naturally comes with a marginal benefit (MB), reducing possibility of contracting an STD.

What the city/county/state/Federal government should do is subsidize the use of condoms. Now I don’t mean just giving them out. In fact condoms are so cheap now these days, that cost is rarely a barrier ((the cost may still be a hindrance for lower income households (in such a case, subsidy should be provided) but I am speaking under the spectrum of a Bathhouse here)). What the government should do, is actually offer a credit for used condoms at Steamworks. What this would do is shift the MB curve of using a condom. Say if an individual gets $1.00 for a used condom, this will give him an incentive to use it (there may also be more people going into Steamworks because I guess under this program they could make money, or at the very least lower the cost of entering; hence, the larger number of people having sex). Less people get sick. We, as taxpayers who pay 1.45% into Medicare will benefit. Condoms may not be perfect, but we are better off if they are used, rather then sitting in CVS.


  1. $1.00 per used condom, that alone would cause many to reach a new tax bracket!

  2. how can steamworks make sure that guys didnt just squirt into the condom after they've had unsafe sex? the idea (shifting the mb / mc of using condom) but not sure if what you mentioned would work. how about providing incentive inside steamworks for getting tested right there and then, so that at least the person being tested would know and if infected has 50/50 chance of going back home to get treated? right now it seems that there's not much incentive to get tested, ironic as that sounds, at least not enough to motivate people to do so. intereseting post and great insight, though. thanks