title: Associations between internet sex seeking and STI associated risk behaviours among men who have sex with men.
abstract: OBJECTIVE
  This exploratory study identified associations between internet sex seeking and HIV associated risk behaviours among a high risk sample of men who have sex with men (MSM).
  
  
  METHODS
  A cross sectional survey of men attending a sex resort was conducted. Of 164 men asked to participate, 91% completed a self administered questionnaire. The questionnaire assessed demographic variables and (using a 3 month recall period) men's HIV associated sexual risk behaviours. Potential confounding variables were assessed and controlled, as needed, by multivariate analysis.
  
  
  RESULTS
  Men currently resided in 14 states. One sixth reported being HIV positive. 57% of the men reported using the internet to seek sex. Differences in critical behaviours (unprotected anal sex and number of partners) were not found. However, compared to those not seeking sex by internet, men using the internet to meet sex partners were more likely to report fisting (adjusted odds ratio = 3.3, p = 0.04), having group sex (prevalence ratio (PR) = 1.2, p = 0.0001), using poppers during sex (PR = 1.94, p = 0.0001), and using ecstasy during sex (PR = 2.7, p = 0.04). Internet sex seeking men were also significantly more likely to report meeting sex partners in bathhouses (PR = 2.2, p = 0.0001), bars (PR = 1.5, p = 0.001), parks (PR = 3.2, p = 0.006), and circuit parties (PR = 8.9, p = 0.007).
  
  
  CONCLUSIONS
  Among MSM attending a sex resort, those using the internet to seek sex partners may have modestly elevated risks for acquiring or transmitting sexually transmitted infections. Subsequent studies should investigate the utility of using the internet as forum for promoting safer sex behaviours among high risk MSM.
authors.affiliation: Rollins School of Public Health, Department of Behavioral Sciences and Health, Education, Atlanta, GA 30322, USA.
authors.forename: A
authors.initials: A
authors.lastname: Mettey
authors.forename: R
authors.initials: R
authors.lastname: Crosby
authors.forename: R J
authors.initials: RJ
authors.lastname: DiClemente
authors.forename: D R
authors.initials: DR
authors.lastname: Holtgrave
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D015999:Multivariate Analysis; D012309:Risk-Taking; D021841:Safe Sex; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology; D014481:United States