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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.

On June 23, 2004 HIV In Site and the Center for AIDS Prevention Studies convened a panel of experts to discuss the increasing popularity of the Internet as a medium to meet sexual partners among men who have sex with men.

Whereas a lot of people in their profiles will put down "safer sex only," then they meet up, that means we do not have to have a discussion about it because, let's say I responded to an ad that said "safer sex only" or we both wrote "safer sex only." However, for me, "safer sex" is "no unprotected anal intercourse" and, for you, "safer sex" is "no anal intercourse at all." And then that is not being discussed. MV: So, is there a misperception with the Internet where it seems clear that you can say, "I'm HIV-negative, STD-free" but that does not get into when you were last tested or what that means for you, and so that it appears that it is all out there in the open but it is really not being addressed?

That is probably not the best example, but let's say for the other person, let's say they won't even have oral sex without a condom. Then you go out and try to find somebody else who potentially has your same thoughts and beliefs. JK: Yes, I think Al Cooper down at Stanford and Michael Ross in Houston, talk about why the Internet is so popular based on these five A's. The Internet is very accessible to many people, particularly in this demographic, particularly here in San Francisco.

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.

The roundtable discussion today is about MSM, sex and Internet chat rooms.