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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.

Participants: Philip Huang, Asian Health Service, Oakland, California; Jeff Klausner, MD, San Francisco Department of Public Health; Deb Levine, Internet Sexuality Information Services, San Francisco; Greg Rebchook, UCSF Center for AIDS Prevention Studies; Frank Strona, Mark Vogel: Welcome to today's roundtable discussion sponsored by HIV In Site and The Center for AIDS Prevention Studies, both at UCSF.

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

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.

It is a lot cheaper to just go online and go to a chat room than to get up, go out of the house and go to a bar or a club or some other venue.

The Internet affords anonymity (There is a great New Yorker slide that says, "On the Internet, no one knows you're a dog.") So you can be whoever you want to be on the Internet.

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 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 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.

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.