Online Access to Risky Sex

A year after testing positive for HIV, a 40-year-old entertainment publicist returns time and again to the “bathhouse” in his backyard. Inside a cinder-block shed, with jazz blaring in the background, he taps away at a computer, trolling for sexual partners.

His bathhouse is the Internet, specifically the Los Angeles chat room of Gay.com, a wildly popular Web site that offers flirtatious banter, personal ads and the opportunity to quickly turn virtual encounters into real-life sex.

“Are you looking to hook up now?” the man writes to a potential partner. Within minutes, the two have traded details of their favorite sexual exploits, swapped photographs and promised to meet later that day.

Two years ago, the publicist met another guy the same way. During sex, the condom broke. That’s how he says he caught the AIDS virus.

“It’s like playing Russian roulette,” he said, speaking on condition of anonymity. “I got the bullet.”

He is not playing alone. Gay and bisexual men looking for quick-turnaround sex increasingly are turning to the Internet, and they are doing so at far greater rates than their heterosexual counterparts. As a result, public-health experts say, they are speeding the spread of HIV and other sexually transmitted diseases.

The same accessibility and anonymity that make the Web so popular also make it increasingly dangerous to sex-seeking users, multiplying “the probability of high-risk people meeting high-risk people,” said Colorado epidemiologist John Potterat. Sex-oriented chat rooms could become “the EBay of homosexual sex,” he said.

Sex among men has long accounted for a large share of sexually transmitted diseases--42% of AIDS cases nationally, for example, and more than 80% of syphilis cases in San Francisco in the last two years.

In the past, officials tried to control the spread of such diseases among gays by targeting common meeting places: closing bathhouses in the 1980s, or requiring condom distribution at bars and adult bookstores.

Now, just as research is suggesting that many gay men are tiring of safer-sex practices, the Internet is opening up a sexual superhighway.

Health officials are woefully ill-equipped to respond. Closing it off or passing out condoms isn’t an option. Moreover, the Web can be an inviting venue for men who don’t typically go to bars or bathhouses and perhaps wouldn’t otherwise engage in high-risk sex.

Officials have no means of systematically monitoring the sites, no new money to launch prevention campaigns and no power to trace infections by demanding that Internet companies identify their clients.

“We are not keeping up,” said Dr. Peter Kerndt, director of sexually transmitted disease control for Los Angeles County. Worse than that, “we have little sense of what approaches would be effective.”

No one knows the precise number of gay men who go online searching for anonymous sex, but judging from use of chat rooms and personal ad sites, it’s a significant subset of the gay population.

Gay.com reported nearly 17.7 million chat sessions in April, up from just 4 million sessions in January 1999. At any given time, up to 18,000 people around the world are conversing in Gay.com’s chat rooms. The provider, which markets its ability to help men find “Mr. Right” and “Mr. Right Now,” says 150,000 members sign on to the chat rooms every day.

Gay.com executives say their site voluntarily provides information on safe sex. But they say they are not responsible for unsafe sex any more than the telephone company is for prank calls.

“You can’t get [a disease] while chatting with somebody on the Internet,” said Lowell Selvin, CEO of PlanetOut Partners, parent company of Gay.com. “You have to physically show up and interact. At that time, you’re governed by rules that are far beyond the scope of our organization.”

The sex-seekers are not only showing up for their trysts, physicians say, they are landing in clinics with infections--notably in California, which has both a large gay population and a high rate of Internet use.

Dr. Gary Cohan, a Beverly Hills physician whose practice treats 2,500 HIV-positive patients, said that as many as 30% meet sex partners online. “That number is rising,” he said, “as people find that it’s an efficient, easy, 24-hour way that they can meet people without having to brush their teeth or comb their hair.”

It’s hard to beat the convenience. And many men like the idea of skipping the small talk at bars and dance clubs.

“You just jump in and you connect, you hook up,” said the publicist, who has a live-in boyfriend. “It’s the fastest way to have sex.”

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Sitting in his ornate living room in San Francisco’s largely gay Castro district, travel agency owner Jonathan Klein expresses hope that chat rooms will bring about a rebirth of sexual exploration.

“There hasn’t been enough acknowledgment of the fact that the sexual freedom of the ‘70s was for a lot of people a really, really wonderful thing,” said Klein, 50, who has lived in San Francisco for 28 years.

Klein, who is HIV positive, said he uses the Internet to search for other HIV-positive men with whom he can have unprotected anal intercourse. Because of his HIV status, Klein said he is willing to accept the consequences of unprotected sex, including other sexually transmitted diseases besides HIV.

Last year, he got syphilis--a “minor inconvenience,” according to Klein. It was treatable with antibiotics, he said, and won’t cause permanent health problems because he sought treatment early on.

“It’s certainly not a wake-up call,” he said. “I don’t intend to change.”

Preliminary research suggests there are lots of men like Klein. Studies have found that gay and bisexual men are two to three times as likely as heterosexual men to seek sexual partners online.

It’s a high-stakes gamble.

In California, Colorado, Kentucky and Maine, among other states, public-health officials have traced outbreaks of sexually transmitted diseases to chat room meetings. In San Francisco, 18% of the gay and bisexual men diagnosed with early forms of syphilis last year said they had found sex partners on the Internet. In Los Angeles County, the figure was 13%.

The Internet makes for speedier transmission of disease over a wider area. If a New Yorker plans to visit Denver next week, he can go online and make plans to meet a sex partner the evening he arrives. At a gay bar in a strange city, hookups are likely to be less certain and take more time.

Many gay men have been quick to embrace the Internet because they are technologically savvy and appreciate the privacy it affords.

But pursuing sex on the Internet also is popular with gay males because, it is believed among evolutionary psychologists, that men in general are more interested in casual sex. Erick Janssen, an associate scientist at the Kinsey Institute for Research in Sex, Gender and Reproduction in Indiana, said he believes heterosexual men would seek sexual liaisons via the Internet far more if not for the comparatively low level of interest among women.

Gay leaders say research shows that the majority of gay men don’t engage in behaviors that place them at risk for HIV.

“We tend to focus on the men who are engaging in anonymous sex ... but we don’t focus on those men who are in committed relationships,” said Jeff Bailey, director of health education and prevention at the Los Angeles Gay and Lesbian Center.

For those who are seeking casual sex, however, the Internet may foster less candor and caution.

“People may be a little less honest about their HIV status and people may loosen up about what they’re willing to do because there’s a lot of fantasy and role play involved,” said Cohan, the Beverly Hills AIDS doctor.

A 39-year-old photographer in San Francisco says he is living with the consequences.

“I was operating with invincibility, thinking that I’m good enough at making judgment calls about a person by looking at them and defining the state of their health,” he said. “How stupid is that?”

Now he has HIV, probably acquired, he says, through an encounter with a man he met on the Internet.

The photographer doesn’t blame the Web sites. In his mind, the real problem is promiscuity among some gay men. They will “connect for sex anywhere they possibly can, and believe me, I mean anywhere,” he said. “Give them the opportunity to create a ‘cruise’ spot somewhere and it will be done.”

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In the summer of 1999, San Francisco health authorities received some disturbing reports: Men were contracting syphilis after meeting partners on America Online’s user chat room, San Francisco M4M (men for men).

Dr. Jeffrey Klausner, the city’s sexually transmitted disease controller, had never heard of anything like this. Nor had any of his colleagues in other cities.

With the help of disease investigators, Klausner linked seven men’s infections to an overlapping network of 99 recent sexual partners. One of the infected men had 47 partners.

Public-health staff and volunteers spent hours in AOL’s chat rooms alerting users to the outbreak, providing facts about syphilis and encouraging testing. They also sent e-mails to partners for whom patients had contact information.

In the end, fewer than half of the seven men’s sexual partners were notified and tested--illustrating the pitfalls of fighting Internet-fueled outbreaks.

Internet users commonly know each other only by computer screen names, and those can change on a daily basis, making partner notification difficult. And Internet providers including AOL won’t release the real identities of users unless required by a court order or if they determine that there is an immediate threat to life, such as suicide or homicide.

Klausner has been pressuring AOL to post syphilis warnings in its San Francisco chat rooms ever since the 1999 syphilis outbreak--without success. Instead, AOL offered to provide complimentary AOL accounts to Klausner’s staffers so they could warn members themselves.

AOL spokesman Nicholas Graham said the company offers a wealth of educational resources on its health channel, and it has run public service announcements about sexually transmitted diseases.

Other Internet companies say they are cooperating fully with health authorities. The San Francisco health department pays Gay.com to run banner advertisements in its West Coast chat rooms and arranges for Klausner to answer users’ questions.

Some in San Francisco’s gay community liken Klausner’s efforts to the forced closing of the city’s bathhouses in 1984. Klein said a shutdown of chat rooms would be “totally unacceptable.” Klausner said he isn’t trying to close chat rooms, only to make them safer.

HIV prevention groups, meanwhile, are resorting to their own piecemeal tactics.

In San Francisco, Karl Knapper and volunteers from the nonprofit agency Stop AIDS visit Gay.com’s Bay Area chat rooms several times a week to answer questions about safer sex and HIV prevention. In all, Knapper, who directs Web outreach for the group, and his volunteers talked to 3,000 people online last year.

He doesn’t have any way of knowing how many of them took the group’s advice to heart. He doesn’t regret trying, though.

“If people miss the boat on the Internet,” Knapper said, “they’ll miss the boat on a whole population that’s at risk for HIV infection. By the time they do realize it, it will be too late.”

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New Orleans resident Keith Griffith, 43, who founded one of the nation’s first casual sex Web sites almost seven years ago, has no qualms about his line of work.

“There’s nothing that makes me happier than when I get an e-mail message from some guy out there who told me about the great sex he’s had as a result of my Web site,” he said. “That is the reason my Web site exists.”

Griffith says the site has 60,000 individual sign-ons every day. He doesn’t charge users for reading, posting or replying to messages; he makes his money selling advertisements and sexual paraphernalia.

Griffith says public-health agencies don’t understand the nature of people who use the Web site. “The simple fact is that some people are going to choose to have unsafe sex, and they’re not necessarily bad people or stupid people,” he said.

Another site, one that promotes unprotected sex, takes a provocative approach to the question of safety. “What about AIDS and HIV?” the site owners write. “What about it?? It will still exist if we have this site up or not. It’s up to you (remember, you are an adult, aren’t you) to decide how you want to run your life ... whom you infect, and what you even believe.”

Those who run more mainstream gay sites say they serve many purposes besides instant sex. Bryce Eberhart, a spokesman for Gay.com, points to “success stories” like Nicholas Picard, who met his boyfriend of 11 months through Gay.com’s personals service. Picard, 23, said the Internet has allowed introverts like him to find partners who aren’t looking for anonymous sexual hookups.

But finding a relationship-oriented guy online was difficult, Picard admitted.

“When I was first coming out, I felt like a piece of meat with vultures descending on me,” said the software engineer who works for a military-related company. “If someone asks you online, ‘Do you want to meet?’ you know what they want. I don’t get the mentality. It drives me nuts.”