A recent outbreak of syphilis among users of an Internet chat room challenged
traditional methods of partner notification and community education because
locating information on sexual partners was limited to screen names and privacy
concerns precluded identifying sexual partners through the Internet service
To determine the association of Internet use and acquisition of syphilis
and to describe innovative methods of partner notification in cyberspace.
Design, Setting, and Patients
Outbreak investigation conducted at the San Francisco (Calif) Department
of Public Health (SFDPH) in June-August 1999 of 7 cases of early syphilis
among gay men linked to an online chat room; case-control study of 6 gay men
with syphilis reported to SFDPH in July-August 1999 (cases) and 32 gay men
without syphilis who presented to a city clinic in April-July 1999 (controls).
Main Outcome Measures
Association of syphilis infection with Internet use, Internet use among
cases vs controls, and partner notification methods and partner evaluation
During the outbreak, cases were significantly more likely than controls
to have met their sexual partners through use of the Internet (67% vs 19%;
odds ratio, 8.7; P = .03). We notified and confirmed
testing for 42% of named partners; the mean number of sexual partners medically
evaluated per index case was 5.9.
In this study, meeting sexual partners through the Internet was associated
with acquisition of syphilis among gay men. Public health efforts must continually
adapt disease control procedures to new venues, carefully weighing the rights
to privacy vs the need to protect public health.