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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.

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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.

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.

Right now, recent data show that more than 80% of sexually active MSM who meet new partners are meeting online in San Francisco, and then what Deb mentioned is approximation that allows people in dense urban areas who are interested to meet up very quickly in a short amount of time.

GR: I just want to add that we have been doing online qualitative interviews with gay and bisexual men or men who have sex with men they meet in Internet chat rooms, or that we were recruiting from Internet chat rooms, and even the guys in rural America are saying that, you know, "I can get online, and in 45 minutes, I can have someone tied up to my bedpost..." So, you know, this is not just in San Francisco or New York; we are seeing this phenomenon in many other places in the country as well.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.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.What differs from the local sex club, though, in one factor is they are not community-based.

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