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I wanted to start the discussion more with evidence because there might be people who are skeptical or do not really understand what evidence there is out there that men who have sex with men and meet their sexual partners online have higher rates of unprotected sex and sexually transmitted diseases. We did a case-control study, which is kind of your typical type of evaluation to determine what risk factors are associated with cases and non-cases.
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.
Frank Strona: One of the things to keep in mind with Internet behavior is there is a perception of anonymity.
It is a cultural norm to be able to put a photograph in the profile out there that does not have a face, it does not have a name associated and I think that there is a level of personal safety that you believe you have, giving the fact that you think people cannot identify you.
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.