The most commonly used venue used by gay men diagnosed with syphilis in the San Francisco area in 2002 and 2003, to meet other gay men for sex was the internet according to a study published in Morbidity and Mortality Weekly on December 19th 2003. A second study published in the December edition of Sexually Transmitted Infections (click here to read an aidsmap report on that study) found that although gay men using the internet to find sexual partners were no more likely to have unprotected anal sex than non-internet users, they were at increased risk of acquiring a sexually transmitted infection.
Syphilis rates have increased significantly amongst gay men in San Francisco, in common with many other urban populations of gay men across Europe and the United States, since 1999. By 2002, San Francisco had the highest rate of syphilis in the United States. Public health officials in San Francisco wished to establish the extent to which gay men with syphilis were using the internet to meet other men for sex, and if the internet could be used for contact tracing and for providing information about syphilis.
Individuals with early syphilis were interviewed by staff from the San Francisco Department of Public Health. Interviewers obtained demographic information, details of sexual risk practices, including condom use, recreational drug use, HIV status, number of sexual partners, and details of where other men were met for sex.
In 2002, a total of 434 cases of early syphilis were diagnosed in gay men in the San Francisco area. These men had a median age of 38 years, two-thirds were white, 67% were HIV-positive, and the men had had a median of six sex partners in the period during which syphilis might have been contracted.
A total of 415 men provided details of the venues they used to meet their partners for sex. Just under a third (32.6%) reported using the internet, 20% said bars, 13% reported using saunas, 12% sex clubs, and 5% pornographic bookstores. Between January 2000 and February 2002, the proportion of gay men with early syphilis who said that they met their partners over the internet increased significantly (p<0.0001) from 12.2 in early 2000 to 37.4% in late 2002. However, a substantial overlap between partner acquisition through the internet and anonymous sex venues remained, suggesting that the internet has played an amplifying role in the renewed spread of syphilis
Investigators also conducted a review of the 151 cases of early syphilis diagnosed in early 2003 in gay men who were interviewed for partner notification purposes. Of these men, 44% reported meeting their partners over the internet, and the health department contacted over a third of their partners and ensured appropriate testing and treatment.
In contrast with anonymous partners met through other venues, health officials were remarkably successful in tracing the contacts of individuals with syphilis who had met partners through the internet. In many cases the men had retained the e-mail addresses of partners, and contact tracing, diagnosis and treatment took place. As a result of its experience, the San Francisco Department of Public Health has developed guidelines on contact tracing via email. To review the guidelines and view the full report, click here.
Further information on this website
Syphilis - overview
Gay internet cruisers no more likely to have unprotected anal sex, says study, but other risks up - news story
Over a third of syphilis cases in Manchester involve HIV-positive gay men and oral sex key to spread - news story
Kent CK et al. Internet use and early syphilis infection among men who have sex with men – Can Francisco, California, 1999 – 2003. Morbidity and Mortality Weekly 52: 1229 – 1232, 2003.