National HIV Prevention Conference Atlanta, Georgia, USA — July 27 - 30, 2003

Natl HIV Prev Conf 2003 July 27-30:abstract no. M1-A0202
Rebchook GM, Curotto A, Kegeles SM
Center for AIDS Prevention Studies/UC San Francisco, San Francisco, CA

BACKGROUND/OBJECTIVES:: High rates of unprotected anal intercourse (UAI) have been reported among MSM who use the Internet to meet sexual partners. This online study describes chatroom-using MSM's Internet use and sexual behavior, and gauges the feasibility of future online HIV-prevention interventions.

METHODS: We recruited MSM from Internet chatrooms to participate in an online qualitative interview and brief online survey. The recruiter entered gay-oriented chatrooms to advertise his presence and describe the study. Interested men contacted him via Instant Messaging or similar technologies. Potential participants were then screened for eligibility. Participants gave their consent electronically before taking a web-based survey and completing a 1-2 hour online interview in real time.

RESULTS: Participants' mean age was 31 (range 18-52; n=91). Their race/ethnicity was: 47% white, 23% Latino, 12% African American, 11% Asian/Pacific-Islander. 38% had at least a college degree. 73% identified as gay and 25% as bisexual. 74% reported being HIV-negative, and 11% HIV-positive. While 33% reported having a boyfriend, only 27% (N=8) of these men were in mutually monogamous relationships lasting > 6 months. These 8 men were excluded from the remaining descriptive analyses. Respondents reported an average of 7 sexual partners in the previous 2 months, and 58% reported UAI. On average, participants used the Internet 20 hours/week for personal purposes. 78% reported, that in the previous 2 months, they had in-person sex with a man they met online (mean number of partners = 5). 39% of the men reported UAI with these "online" partners. Preliminary results of a thematic analysis of the interviews reveal the Internet has allowed respondents to socialize and to access resources and support anonymously, and it has been vital to the sexual identity development and self-expression of many participants. Additionally, many developed and sustained supportive interpersonal relationships via the Internet. Respondents felt their online activities have increased their number of sexual partners and changed their sexual self-expression and/ or practices. A variety of HIV risk-reduction strategies were reported, including: 100% avoidance of anal sex; 100% condom use for anal sex with no discussion of HIV status/safer sex; 100% condom use for anal sex after mutual disclosure/discussion of safer sex. Examples of less safe behavior include men who: engage in occasional UAI (without discussing HIV status or condoms); use condoms with their Internet partners but engage in UAI with "known" partners; have UAI with Internet partners after mutual disclosure of HIV negative status; and have UAI with Internet partners with no discussion of HIV status or condoms unless their partners insist. Many men left condom use decisions to their partners. Nearly all men said that they would participate in online prevention programs but were unaware of current projects.

CONCLUSIONS: The Internet plays an important and multi-faceted role in the lives of the men in our study. Since study participants spend a significant amount of time online and report high rates of UAI and multiple sex partners, the Internet may be a compelling medium through which to deliver HIV-prevention services to a difficult-to-reach population.

030727
M1-A0202

Copyright notice: The National HIV Prevention Conference is collaborative effort by the Centers for Disease Control and Prevention, a U.S. Government agency and other governmental and non-government organizations. All abstracts published in by the conference organizers are in the public domain and can be used without permission. Proper citation, however, is required.