This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (133)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • HIV/AIDS  • Sexually Transmitted Diseases  • Informatics/ Internet in Medicine  • Internet  • Infectious Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

Mary McFarlane, PhD; Sheana S. Bull, PhD, MPH; Cornelis A. Rietmeijer, MD, MPH

JAMA. 2000;284:443-446.

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.

Author Affiliations: Division of Sexually Transmitted Disease Prevention, Centers for Disease Control and Prevention, Atlanta, Ga (Dr McFarlane); and Denver Public Health Department, Denver Health and Hospital Authority, Denver, Colo (Drs Bull and Rietmeijer).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Tracing a Syphilis Outbreak Through Cyberspace
Jeffrey D. Klausner, Wendy Wolf, Lyn Fischer-Ponce, Ilene Zolt, and Mitchell H. Katz
JAMA. 2000;284(4):447-449.
ABSTRACT | FULL TEXT  

Sex and Cyberspace—Virtual Networks Leading to High-Risk Sex
Kathleen E. Toomey and Richard B. Rothenberg
JAMA. 2000;284(4):485-487.
EXTRACT | FULL TEXT  

July 26, 2000
JAMA. 2000;284(4):505-506.
EXTRACT | FULL TEXT  

Syphilis
JAMA. 2000;284(4):520.
PDF  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Performance of Three Nucleic Acid Amplification Tests for Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by Use of Self-Collected Vaginal Swabs Obtained via an Internet-Based Screening Program
Masek et al.
J. Clin. Microbiol. 2009;47:1663-1667.
ABSTRACT | FULL TEXT  

Finding sex partners on the internet: what is the risk for sexually transmitted infections?
Al-Tayyib et al.
Sex. Transm. Infect. 2009;85:216-220.
ABSTRACT | FULL TEXT  

Forensic Evaluation of Problematic Internet Use
Recupero
J Am Acad Psychiatry Law 2008;36:505-514.
ABSTRACT | FULL TEXT  

Trends in sexually transmitted infections (other than HIV) in older people: analysis of data from an enhanced surveillance system
Bodley-Tickell et al.
Sex. Transm. Infect. 2008;84:312-317.
ABSTRACT | FULL TEXT  

Acceptability of an Internet-Based Partner Notification System for Sexually Transmitted Infection Exposure Among Men Who Have Sex With Men
Mimiaga et al.
AJPH 2008;98:1009-1011.
ABSTRACT | FULL TEXT  

Online Dating and Mating: The Use of the Internet to Meet Sexual Partners
Couch and Liamputtong
Qual Health Res 2008;18:268-279.
ABSTRACT  

Short-Term Impact Evaluation of a Social Marketing Campaign to Prevent Syphilis Among Men Who Have Sex With Men
Darrow and Biersteker
AJPH 2008;98:337-343.
ABSTRACT | FULL TEXT  

Internet use and risk behaviours: an online survey of visitors to three gay websites in China
Zhang et al.
Sex. Transm. Infect. 2007;83:571-576.
ABSTRACT | FULL TEXT  

Using sexual affiliation networks to describe the sexual structure of a population
Frost
Sex. Transm. Infect. 2007;83:i37-i42.
ABSTRACT | FULL TEXT  

Prevalence of HIV Infection and Predictors of High-Transmission Sexual Risk Behaviors Among Men Who Have Sex With Men
Schwarcz et al.
AJPH 2007;97:1067-1075.
ABSTRACT | FULL TEXT  

Testing for sexually transmitted infections: a brave new world?
Peeling
Sex. Transm. Infect. 2006;82:425-430.
FULL TEXT  

Increases in sexually transmitted infections and sexual risk behaviour without a concurrent increase in HIV incidence among men who have sex with men in San Francisco: a suggestion of HIV serosorting?
Truong et al.
Sex. Transm. Infect. 2006;82:461-466.
ABSTRACT | FULL TEXT  

Individual characteristics are less important than event characteristics in predicting protected and unprotected anal intercourse among homosexual and bisexual men in Melbourne, Australia
Smith et al.
Sex. Transm. Infect. 2006;82:474-477.
ABSTRACT | FULL TEXT  

Rapid tests for sexually transmitted infections (STIs): the way forward
Peeling et al.
Sex. Transm. Infect. 2006;82:v1-v6.
ABSTRACT | FULL TEXT  

'You show me yours, I'll show you mine': the negotiation of shifts from textual to visual modes in computer-mediated interaction among gay men
Jones
Visual Communication 2005;4:69-92.
ABSTRACT  

Recent trends in HIV and other STIs in the United Kingdom: data to the end of 2002
Brown et al.
Sex. Transm. Infect. 2004;80:159-166.
ABSTRACT | FULL TEXT  

Associations between internet sex seeking and STI associated risk behaviours among men who have sex with men
Mettey et al.
Sex. Transm. Infect. 2003;79:466-468.
ABSTRACT | FULL TEXT  

Determinants of STD epidemics: implications for phase appropriate intervention strategies
Aral
Sex. Transm. Infect. 2002;78:i3-13.
ABSTRACT | FULL TEXT  

Barriers to STD/HIV prevention on the Internet
Bull et al.
Health Educ Res 2001;16:661-670.
ABSTRACT | FULL TEXT  

Consumer health information seeking on the Internet: the state of the art
Cline and Haynes
Health Educ Res 2001;16:671-692.
ABSTRACT | FULL TEXT  

Six-Year Study of the Incidence of Herpes in Genital and Nongenital Cultures in a Central Kentucky Medical Center Patient Population
Ribes et al.
J. Clin. Microbiol. 2001;39:3321-3325.
ABSTRACT | FULL TEXT  

Is Cyberspace Dangerous?
JWatch Psychiatry 2000;2000:1-1.
FULL TEXT  

STDs, Cyberspace, and Public Health
JWatch Infect. Diseases 2000;2000:10-10.
FULL TEXT  

When Cybersex Leads to Real Disease
JWatch General 2000;2000:2-2.
FULL TEXT  

Sex and Cyberspace--Virtual Networks Leading to High-Risk Sex
Toomey and Rothenberg
JAMA 2000;284:485-487.
FULL TEXT