title: A comparison of on-line and off-line sexual risk in men who have sex with men: an event-based on-line survey.
abstract: OBJECTIVE
  To assess whether men who have sex with men (MSM) are more likely to report unprotected anal intercourse (UAI) with partners met on-line compared with those met off-line.
  
  
  METHODS
  A total of 6122 individuals consented to participate in an anonymous behavioral survey on-line. This event-based analysis is limited to the 1683 men from the United States and Canada who had sex in the 3 months before the study and reported that their last sexual encounter included a new or casual male partner or partners. Prevalence and predictors of UAI were analyzed separately for the 386 men reporting more than 1 partner (multiple) and the 1297 men reporting only 1 (single) partner in their last encounter.
  
  
  RESULTS
  Of the 1683 MSM recruited on-line, 51% met their partner(s) in their last sexual encounter on-line and 23% reported UAI. No difference in risk for UAI was found for partners met on-line versus off-line in the bivariate or multivariate analyses. In a multivariate analysis of men with multiple-partner encounters, UAI was significantly associated with being HIV-seropositive (adjusted odds ratio [OR] = 2.87; P = 0.02) in a model that included age; education; whether partners were met on-line or off-line; and use of crystal methamphetamine, sildenafil, or alcohol before sex. Using the same model, significant predictors of UAI in men reporting a single-partner encounter were use of crystal methamphetamine (adjusted OR = 5.67; P = 0.001) and no college degree (adjusted OR = 1.63; P = 0.01).
  
  
  CONCLUSIONS
  MSM recruited on-line who reported a new or casual sex partner(s) in the prior 3 months are at considerable risk of HIV or other sexually transmitted infections, but they are equally likely to report UAI whether sex partners were met on-line or off-line. The Internet may be an ideal venue for reaching high-risk MSM.
authors.affiliation: Medical and Health Research Association of New York City, New York 10013, USA. machiasson@mhra.org
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Chiasson
authors.forename: Sabina
authors.initials: S
authors.lastname: Hirshfield
authors.forename: Robert H
authors.initials: RH
authors.lastname: Remien
authors.forename: Mike
authors.initials: M
authors.lastname: Humberstone
authors.forename: Tom
authors.initials: T
authors.lastname: Wong
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wolitski
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002170:Canada; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006306:Health Surveys; D018451:Homosexuality, Male; D006801:Humans; D020407:Internet; D007398:Interpersonal Relations; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors; D012309:Risk-Taking; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D019966:Substance-Related Disorders; D014481:United States; D047568:Unsafe Sex / Q000706:statistics & numerical data*