Internet Use and the Spread of HIV Infection

By Elizabeth Tracey, Senior Medical Editor

Gay men looking for sex partners are using technology to do so. Recent studies indicate that the Internet is an extremely popular means for contacting like-minded people. According to one study, more than 80 percent of gay men report having met sex partners online. Unfortunately, studies of Internet-initiated contacts indicate, 60 percent of these men are having unprotected sex, causing some infectious disease and public health researchers to liken the Internet to the bathhouse culture popular among some gay men before the advent of AIDS.

Management of HIV not always easy

"It's quite possible that gay men now view HIV infection as a chronic disease, capable of being managed with highly active antiretroviral therapy, or HAART," says Emily Erbelding, M.D., M.P.H., assistant professor of infectious diseases at Johns Hopkins. "It should be emphasized that while a person may be getting benefit from HAART, if they have unprotected sex with HIV-infected partners they are running the risk of becoming infected with multiple strains of HIV, which may be drug-resistant. As health professionals we must educate gay men, and in fact anyone who is infected with HIV, that this is the case."

Erbelding has studied syphilis outbreaks around the country related to Internet chat room connections, where visitors are frequently looking for anonymous sex, sex in certain specific positions or with someone with very particular physical characteristics. "We have clearly seen the reemergence of syphilis and of high-risk behavior among some gay men," she says. "By inference from the syphilis data, I believe HIV is likely to be transmitted as well."

Sick of the problem

One of the biggest problems to overcome among this group is called "safe sex fatigue." In other words, gay men are simply tired of hearing global warnings about HIV infection and AIDS, much like smokers who don't want to hear anything more about lung cancer and emphysema. Focus groups have been conducted around the U.S. to discern how best to deliver public health messages that gay men will heed.

"As health care providers we must ask questions about sexual behaviors in a nonjudgmental way, which many providers may be untrained or uncomfortable doing," says Erbelding. "But by asking these questions, we can create more opportunities for providing information and counseling so people don't take unnecessary risks."

Club drugs implicated

Another issue that both gay and heterosexual people need to be concerned about is the use of drugs like Ecstasy and Viagra in a club setting. "When people use drugs such as these they definitely increase their risk-taking behavior," Erbelding emphasizes. "Concerns about safe sex may be disregarded in the pleasure of the moment, but unfortunately, once someone is infected with HIV there is no cure."

Last Updated: 3/13/2003
The Johns Hopkins University 1996-2003.  All rights reserved.  This information is not intended to provide advice on personal medical matters, nor is it intended to be a substitute for consultation.