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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.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.Joining me today are several individuals, all of whom either as public health officials, researchers, safe sex advocates or some combination thereof, have a particular interest and expertise in Internet chat room use among MSM. Frank has worked on men's sex and health issues for more than 15 years. He is assistant research psychologist and has studied and worked on a number of community-based interventions among gay men.He is co-creator of a new website called Safe Sex City.com, which is a cyber-community geared towards creating a community of like-minded MSM who are committed to promoting and practicing of safe sex. He has conducted research on the role of the Internet in the sexual lives of MSM and has found a number of interesting trends that I am sure he will share with us in our discussion today.

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The owners could be in New York or be in Ohio and that is where they launched your national website from, and you could have people all over the country using the site.

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.

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 was actually one of the first published studies of a strong association between Internet sex partnering and syphilis transmission.

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