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The Internet as a newly emerging risk environment for sexually
transmitted diseases.
Journal of the American Medical Association 2000;284(4):443-446.
McFarlane M, Bull SS, Rietmeijer CA.
Abstract
CONTEXT: Transmission of sexually transmitted diseases (STDs) such as human
immunodeficiency virus (HIV) infection is associated with unprotected sex
among multiple anonymous sex partners. The role of the Internet in risk of
STDs is not known. OBJECTIVE: To compare risk of STD transmission for persons
who seek sex partners 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
intention of finding sex partners; having sex with partners who were originally
contacted via the Internet; number of such partners and use of condoms with
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%), heterosexual (65.3%), and aged 20 to 50 years
(84. 1%). Of those, 135 (15.8%) had sought sex partners on the Internet,
and 88 (65.2%) of these reported having sex with a partner initially met
via the Internet. Of those with Internet partners, 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 seekers 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 previous 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 partners 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
practice in this sample of persons seeking HIV testing and counseling (representative
of neither Denver nor the overall US population). Clients who seek sex using
the Internet appear to be at greater risk for STDs than clients who do not
seek sex on the Internet. JAMA. 2000;284:443-446.