What sort of trends or similarities do you see in terms of behavior, safety, and expectations? One is I do think it is important to recognize that when people are hooking up, when they are meeting each other online and then going home, that it is happening in an environment that has traditionally been isolated from HIV prevention messages and that whatever your perceptions are of the campaigns that are going on currently in the bars and bath houses, there are posters there; there are condoms available there; there are very visible and active campaigns happening in many communities across the U. And at some point, in some of the communities where we were asking people online if they were aware of online HIV prevention campaigns, many of the participants said they were not aware or they had not seen them because, I mean, I think the Internet is so large that it takes a really concerted effort to make your presence known and so that when hookups are being arranged completely outside of the arena that HIV prevention campaigns have hit, I think that is worth talking about.
So I would like to welcome all of the panelists today and thank you for joining us here. There are also higher rates of men reporting STD infections, who are using chat rooms, and so it is a very consistent finding that a lot of different studies and a lot of different research groups are picking up that these higher rates are existing.
I am going to go ahead and begin with the first set of questions. Greg Rebchook: Sure, I can start addressing that question about evidence that MSM recruited from online venues or using chat rooms have higher rates of, or they are reporting higher rates of, unprotected anal intercourse with their partners than men in other venues. Our own data actually show that even when you are controlling for the number of sexual partners that men are having, that Internet use still contributes to unprotected sex significantly, even controlling for the number of sex partners. Jeff Klausner: We first identified the association of Internet use and STD transmission in 1999 during an outbreak investigation of a cluster of syphilis cases among gay men here in San Francisco.
It was actually one of the first published studies of a strong association between Internet sex partnering and syphilis transmission.
As part of that study, we continued to monitor the use of Internet chat rooms and Internet sites among syphilis case patients and non-patients seen at the STD clinic in San Francisco and how about half of new cases have met recent partners online and the Internet sites have continued to be a place where we focus prevention efforts.
I wanted to start the discussion more with evidence because there might be people who are skeptical or do not really understand what evidence there is out there that men who have sex with men and meet their sexual partners online have higher rates of unprotected sex and sexually transmitted diseases. We did a case-control study, which is kind of your typical type of evaluation to determine what risk factors are associated with cases and non-cases.
In this investigation, we found that 67% of these syphilis cases versus 19% of matched men who were non-syphilis cases had met recent partners in the chat room, and this was a statistically significant association.
On June 23, 2004 HIV In Site and the Center for AIDS Prevention Studies convened a panel of experts to discuss the increasing popularity of the Internet as a medium to meet sexual partners among men who have sex with men.
Participants: Philip Huang, Asian Health Service, Oakland, California; Jeff Klausner, MD, San Francisco Department of Public Health; Deb Levine, Internet Sexuality Information Services, San Francisco; Greg Rebchook, UCSF Center for AIDS Prevention Studies; Frank Strona, Mark Vogel: Welcome to today's roundtable discussion sponsored by HIV In Site and The Center for AIDS Prevention Studies, both at UCSF.
The roundtable discussion today is about MSM, sex and Internet chat rooms.