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Frank Strona: One of the things to keep in mind with Internet behavior is there is a perception of anonymity.It is a cultural norm to be able to put a photograph in the profile out there that does not have a face, it does not have a name associated and I think that there is a level of personal safety that you believe you have, giving the fact that you think people cannot identify you.The Internet affords anonymity (There is a great New Yorker slide that says, "On the Internet, no one knows you're a dog.") So you can be whoever you want to be on the Internet.Internet partnering has become very acceptable, so that it has become the new relative norm of how to meet partners.But I really do think a lot of it is based on comfort level of perceived anonymity. I do not want to start off by blaming the Internet and saying, you know, "This medium is the reason that there are higher transmission rates." It is yet another way that men can meet men and a lot of the people who are meeting men on the Internet are also meeting men in bars and clubs and bath houses and parks and everywhere else. Adding to that, though, the Internet allows men to meet each other faster.
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.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.And we really ask people how they thought the Internet was affecting their sexual behaviors and to the T, almost everyone said that it has been increasing the number of partners they have and then either look at that as something really positive-that it is convenient, it is accessible, that it is sort of the greatest thing-and other people are sort of indicating some level of frustration with that, well, while they can get their physical needs met pretty easily, sometimes their unexpressed needs around intimacy might not be getting met, although that can be true in other venues as well, but I think the explosion in the number of partners people are meeting online is really changing that for some of the guys that we have been interviewing.MV: So, what sort of comparisons can we make between Internet chat rooms and other venues where the goal the sort of the same and very obvious, such as sex clubs; there are sex clubs in the City and a lot of other cities.