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The Internet and HIV/STD prevention

As we continue into the third decade of the HIV/AIDS epidemic, we find risk for sexual transmission evolving with the advent of new technologies and the emergence of new social and sexual venues. The recent increase in syphilis incidence and new diagnoses of HIV infection among men who have sex with men (MSM) has led public health workers to investigate with renewed energy the sexual behaviors and networks that lead to disease transmission. Of particular interest is the recent trend in sexual partner seeking on the Internet. With its ability to facilitate fast, anonymous and potentially risky sexual encounters, the Internet represents a powerful challenge for sexually transmitted disease (STD) and HIV prevention. It also represents a golden opportunity to gain access to a population we may not necessarily encounter in clinic and community settings. While a clear association has emerged between seeking sex on the Internet and risky sexual behavior among MSM, the underlying processes are incompletely understood. As a consequence, the exact nature of the appropriate public health response is not immediately obvious. To address this issue, the Division of STD Prevention of the US Centers for Disease Control and Prevention (CDC), in collaboration with the National Coalition of STD Directors (NCSD), organized a conference in August 2003 in Washington, DC. The conference, called ‘STD/HIV Prevention and the Internet’, was attended by public health field-staff, academic and government researchers, outreach workers, community-based organizations, web-masters and health educators predominantly, but not only, from the USA. The goal of the conference was to understand the potential of the Internet as both an emerging risk environment and a venue for intervention, outreach, disease control and health promotion. Presentations covered a wide variety of topics detailing successes and, equally important, some failures with online efforts. Some of the presentations from the conference were subsequently written up as full papers and independently peer-reviewed for inclusion in this issue of AIDS Care . As with most new fields of study, this first conference on HIV/STD prevention and the Internet raised a number of important questions. For example, is it possible to intervene with MSM while they are in the act of seeking sex partners online? Are existing health promotion