The Internet as a newly emerging risk environment for sexually transmitteddiseases

Context Transmission of sexually transmitted diseases (STDs) such as human immunodeficiency virus (HIV) infection is associated with unprotected sex a mong multiple anonymous sex partners. The role of the Internet in risk of S TDs is not known. Objective To compare risk of STD transmission for persons who seek sex part ners on the Internet with risk for persons not seeking sex partners on the Internet. Design Cross-sectional survey conducted September 1999 through April 2000, Setting and Participants A total of 856 clients of the Denver Public Health HIV Counseling and Testing Site in Colorado. Main Outcome Measures Self-report of logging on to the Internet with the in tention of finding sex partners; having sex with partners who were original ly contacted via the Internet; number of such partners and use of condoms w ith them; and time since last sexual contact with Internet partners, linked to HIV risk assessment and test records. Results Of the 856 clients, most were white (77.8%), men (69.2%), heterosex ual (65.3%), and aged 20 to 50 years (84.1%), Of those, 135 (15.8%) had sou ght sex partners on the Internet, and 88 (65.2%) of these reported having s ex with a partner initially met via the Internet, Of those with Internet pa rtners, 34 (38.7%) had 4 or more such partners, with 62 (71.2%) of contacts occurring within 6 months prior to the client's HIV test. Internet sex see kers were more likely to be men (P<.001) and homosexual (P<.001) than those not seeking sex via the Internet. Internet sex seekers reported more previ ous STDs (P=.02); more partners (P<.001); more anal sex (P<.001); and more sexual exposure to men (P<.001), men who have sex with men (P<.001), and pa rtners known to be HIV positive (P<.001) than those not seeking sex via the Internet, Conclusions Seeking sex partners via the Internet was a relatively common p ractice in this sample of persons seeking HIV testing and counseling (repre sentative of neither Denver nor the overall US population). Clients who see k sex using the Internet appear to be at greater risk for STDs than clients who do not seek sex on the Internet.