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It is a cultural norm to be able to put a photograph in the profile out there that does not have a face, it does not have a name associated and I think that there is a level of personal safety that you believe you have, giving the fact that you think people cannot identify you.

So you can write your profile as a modified code, hoping other people will read it the same way and then you can have a combination of emails exchanged or messages exchanged that allows you to kind of refine where and what behavior you choose to go to and then, if you want to have that next step, you can display your face.

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.

Frank Strona: One of the things to keep in mind with Internet behavior is there is a perception of anonymity.

ISIS has worked with online providers to provide online prevention initiatives. have documented high rates of unprotected sex among men recruited from online venues and there are several European studies that have looked at comparing, guys who say that they actually are using chat rooms to those that are not using chat rooms and there is a lot of information, a lot of data, showing that the chat room users are actually reporting higher rates of unprotected sex than the non-chat room users.

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

The downside of that is, more often than not, in such small locations that we have, you end up knowing who the people are even before you see the face shot, and once you get more and more comfortable and you find less and less fear based on whatever program you are in, you start to change those images.

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.

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.

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

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