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What sort of trends or similarities do you see in terms of behavior, safety, and expectations? One is I do think it is important to recognize that when people are hooking up, when they are meeting each other online and then going home, that it is happening in an environment that has traditionally been isolated from HIV prevention messages and that whatever your perceptions are of the campaigns that are going on currently in the bars and bath houses, there are posters there; there are condoms available there; there are very visible and active campaigns happening in many communities across the U. And at some point, in some of the communities where we were asking people online if they were aware of online HIV prevention campaigns, many of the participants said they were not aware or they had not seen them because, I mean, I think the Internet is so large that it takes a really concerted effort to make your presence known and so that when hookups are being arranged completely outside of the arena that HIV prevention campaigns have hit, I think that is worth talking about.

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I am going to go ahead and begin with the first set of questions. Greg Rebchook: Sure, I can start addressing that question about evidence that MSM recruited from online venues or using chat rooms have higher rates of, or they are reporting higher rates of, unprotected anal intercourse with their partners than men in other venues. Our own data actually show that even when you are controlling for the number of sexual partners that men are having, that Internet use still contributes to unprotected sex significantly, even controlling for the number of sex partners. Jeff Klausner: We first identified the association of Internet use and STD transmission in 1999 during an outbreak investigation of a cluster of syphilis cases among gay men here in San Francisco.That does not make you a "local" community organization tied to that particularly community, which then creates a challenge in terms of working with the local sex venue to say, "Okay, we would like you to put up more posters." They are there to make money and they are going to after the situation that is going to cause their membership the least trauma, the least discomfort and the least reality, in some cases.JK: In our work, it seems that people who attend sex clubs and seek sex at sex clubs seem to be somewhat different than people who are seeking sex online, different from people who may seek sex through more kind of casual street-based or social encounters, and surprisingly, there is actually not a lot of overlap.Okay, so then you get together and you think that you are going to have a particular kind of experience, you are already there, you are already aroused, you give up some of the discussion because it is much easier to just follow through and then afterwards you are like, "Man, you know? Internet access to places where you can meet sex partners is very affordable.It is a lot cheaper to just go online and go to a chat room than to get up, go out of the house and go to a bar or a club or some other venue.On June 23, 2004 HIV In Site and the Center for AIDS Prevention Studies convened a panel of experts to discuss the increasing popularity of the Internet as a medium to meet sexual partners among men who have sex with men.

Participants: Philip Huang, Asian Health Service, Oakland, California; Jeff Klausner, MD, San Francisco Department of Public Health; Deb Levine, Internet Sexuality Information Services, San Francisco; Greg Rebchook, UCSF Center for AIDS Prevention Studies; Frank Strona, Mark Vogel: Welcome to today's roundtable discussion sponsored by HIV In Site and The Center for AIDS Prevention Studies, both at UCSF.

Joining me today are several individuals, all of whom either as public health officials, researchers, safe sex advocates or some combination thereof, have a particular interest and expertise in Internet chat room use among MSM. Frank has worked on men's sex and health issues for more than 15 years. He is assistant research psychologist and has studied and worked on a number of community-based interventions among gay men.

He is co-creator of a new website called Safe Sex City.com, which is a cyber-community geared towards creating a community of like-minded MSM who are committed to promoting and practicing of safe sex. He has conducted research on the role of the Internet in the sexual lives of MSM and has found a number of interesting trends that I am sure he will share with us in our discussion today.

Right now, recent data show that more than 80% of sexually active MSM who meet new partners are meeting online in San Francisco, and then what Deb mentioned is approximation that allows people in dense urban areas who are interested to meet up very quickly in a short amount of time.

GR: I just want to add that we have been doing online qualitative interviews with gay and bisexual men or men who have sex with men they meet in Internet chat rooms, or that we were recruiting from Internet chat rooms, and even the guys in rural America are saying that, you know, "I can get online, and in 45 minutes, I can have someone tied up to my bedpost..." So, you know, this is not just in San Francisco or New York; we are seeing this phenomenon in many other places in the country as well.

And we really ask people how they thought the Internet was affecting their sexual behaviors and to the T, almost everyone said that it has been increasing the number of partners they have and then either look at that as something really positive-that it is convenient, it is accessible, that it is sort of the greatest thing-and other people are sort of indicating some level of frustration with that, well, while they can get their physical needs met pretty easily, sometimes their unexpressed needs around intimacy might not be getting met, although that can be true in other venues as well, but I think the explosion in the number of partners people are meeting online is really changing that for some of the guys that we have been interviewing.