Online Intervention Paramount for Reducing HIV in High Risk Population

Group also more likely to report substance abuse

ST. PAUL / MINNEAPOLIS (April 29, 2008) -- Young Internet-using men who have sex with men and who meet their sexual partners both online and offline have greater numbers of partners, appear more likely to contract HIV, and report higher substance use rates than those who meet their partners exclusively online or offline, according to new research at the University of Minnesota.

About 45 percent of the group reported unprotected anal intercourse in the past three months, according to the research. A smaller number of those who met partners exclusively online (29 percent) or exclusively offline (34 percent) reported having unprotected anal sex in the past three months.

Men who have sex with men who met partners exclusively offline reported the fewest number of partners, but the greatest number of partnerships involving unprotected anal intercourse (49 percent). Meeting partners both online and offline and being drunk or high during the last sexual encounter increased the odds of having more partners and engaging in unprotected anal intercourse.

"We've known since about 2000 that the Internet has dramatically changed HIV risk for gay men and other men who have sex with men," said Simon Rosser, Ph.D., principal investigator on the study and professor in the School of Public Health’s Division of Epidemiology and Community Health. "But the early reports were small case studies with very broad results. What is so exciting about this paper is that we starting to understand some of the more subtle differences so we can get beyond broad generalizations to a real understanding of the risk, and then design effective responses."

Young men, ages 18-24, who have sex with men are disproportionately affected by the HIV/AIDS epidemic in the United States. In 2003, male-to-male sexual contact accounted for 74 percent of HIV diagnoses among young males between the ages of 13 and 24 years in the United States. And the estimated annual number of HIV cases among young men rose from 1,763 in 1999 to 2,443 in 2003.

Researchers surveyed 770 Internet-using young men who have sex with men about their sexual risk behaviors to examine whether risk for HIV differed between those who met their partners exclusively online, exclusively offline, or both online and offline. Those who participated completed a 45-minute online survey regarding sex and Internet use and must have had sex in the past three months.

The study results are published online today in the American Journal of Public Health.

"The Internet is a popular and easy way for men who have sex with men to meet partners, and our findings suggest that online sex seeking neither promotes nor discourages unprotected anal intercourse," said Keith Horvath, Ph.D., assistant professor in the Division of Epidemiology and Community Health and investigator on the study.

Rather than focusing on the dangers of online sex seeking, Internet-based programs, similar to offline interventions, should encourage at-risk young men who have sex with men to decrease the frequency at which they engage in unprotected anal intercourse, reduce their numbers of sexual partners, avoid alcohol and other substance use in sexual situations, and seek HIV testing, Horvath said.

More than one-quarter of the men in the study had not been tested for HIV.

"There is a need and a demand for online health promotion and disease prevention services, and the Internet creates an opportunity to access large numbers of otherwise difficult-to-reach and vulnerable people," Horvath said.

As part of the broader study, Rosser has led a group of investigators to develop one of the world’s first online HIV risk reduction interventions, called "SexPulse." A randomized controlled trial testing the effects of SexPulse, currently in progress, will be completed later this year.

The study was funded by the National Institute of Mental Health.

For more than 60 years, the University of Minnesota School of Public Health has been among the top accredited schools of public health in the nation. With a mission focused on research, teaching, and service, the school attracts nearly $70 million in sponsored research each year, has more than 100 faculty members and more than 1,300 students, and is engaged in community outreach activities locally, nationally and in dozens of countries worldwide. For more information, visit www.sph.umn.edu. The School’s Centers for Public Health Education and Outreach promotes lifelong learning to bridge academic and public health practice communities.

The Academic Health Center is home to the University of Minnesota’s six health professional schools and colleges as well as several health-related centers and institutes. Founded in 1851, the University is one of the oldest and largest land grant institutions in the country. The AHC prepares the new health professionals who improve the health of communities, discover and deliver new treatments and cures, and strengthen the health economy.

Contact:
Nick Hanson, Academic Health Center, (612) 624-2449, hans2853@umn.edu

Molly Portz, Academic Health Center, (612) 625-2640, mportz@umn.edu