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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.

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.

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.What sort of trends or similarities do you see in terms of behavior, safety, and expectations? One is I do think it is important to recognize that when people are hooking up, when they are meeting each other online and then going home, that it is happening in an environment that has traditionally been isolated from HIV prevention messages and that whatever your perceptions are of the campaigns that are going on currently in the bars and bath houses, there are posters there; there are condoms available there; there are very visible and active campaigns happening in many communities across the U. And at some point, in some of the communities where we were asking people online if they were aware of online HIV prevention campaigns, many of the participants said they were not aware or they had not seen them because, I mean, I think the Internet is so large that it takes a really concerted effort to make your presence known and so that when hookups are being arranged completely outside of the arena that HIV prevention campaigns have hit, I think that is worth talking about.PS: It is also important, I think, to keep in mind that these websites are businesses -- the owners are out making money.That does not make you a "local" community organization tied to that particularly community, which then creates a challenge in terms of working with the local sex venue to say, "Okay, we would like you to put up more posters." They are there to make money and they are going to after the situation that is going to cause their membership the least trauma, the least discomfort and the least reality, in some cases.JK: In our work, it seems that people who attend sex clubs and seek sex at sex clubs seem to be somewhat different than people who are seeking sex online, different from people who may seek sex through more kind of casual street-based or social encounters, and surprisingly, there is actually not a lot of overlap.