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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.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.You get on line, you want to get laid, you can have somebody at your house within an hour -- probably less in San Francisco! If you are experience is one that you are not crazy about, you can get back online and you can find somebody else to come over or to go to their house afterwards.It is a lot harder when you are working face-to-face because you have to sort of summon up the effort to talk to somebody and to break the ice and to ask them to come home with you; whereas the Internet, everybody is there for the same reason; it is very quick, it is very easy.The other reason why I think that there are problems with communication via the Internet, is -- and I think it is really just a continuum of what is happening offline -- is that safer sex does not seem to hold much meaning on the Internet anymore.

But we are here to address the questions of why this is the case, what evidence there is to support these studies and these trends, and to set out what makes Internet chat rooms different from other venues.

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.

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.

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