Background:
Internet chat rooms have become primary venues for seeking sexual partners.

Objective:
To describe sexual risk among men who seek partners online.

Method:
Findings are from an online study of STD risk indicators for 616 MSM with sex partners found via the Internet and those who found partners off-line; indicators included frequencies of anal intercourse, knowledge of partners' STD/HIV infection status, use of alcohol/drugs prior to sex, and condom use during anal intercourse with last partner.

Result:
Among this mature (median age 35), mostly white (86.6%), well-educated (54.9% > college graduate), and higher income (49.0% > $40,000 /yr) sample of mostly gay men (83.4%): 61.8% had anal intercourse with sex partners at least half the time, 28.1% knew the HIV status and 46.7% knew the STD status/history of sex partners less than half the time, and 24.1% were drunk or high before sex at least half the time. 45.9% of men reported not using condoms during last sex. Men with Internet partners were more likely to know their partners' HIV status (p<0.05) and less likely to be intoxicated before sex (p < 0.01) when compared to men with off-line partners. The median number of lifetime sex partners was 50 (IQR: 20-160), of which half were found online. 16.9% of men increased their level of risk with Internet vs. off-line partners. Factors associated with increased risk included age > 35 (OR = 2.63; p = 0.02) and being HIV+ (OR = 2.53; p= 0.12).

Conclusion:
The Internet is a venue for MSM with high sexual risk, but men with partners found via Internet more often know their partners' HIV status and report less rates of intoxication during sex than partners found off-line. A small proportion of men (older, tended to be HIV+) reported increased risk with online partners.

Implications:
In evaluating the level of HIV risk among MSM, healthcare providers should identify whether patients/clients use the Internet to meet sex partners-- as these men often have anal intercouse without condoms, and often do not know the HIV or STD infection status of sex partners. HIV/STD prevention specialists should tailor messages to address the high levels of sexual risk indicators in these men.