Finding sex partners on the internet: what is the risk for sexually transmitted infections?

To assess the association between sexual encounters with internet partners and current Chlamydia trachomatis (Ct) and Neisseria gonorrhoeae (GC) infections.

Between August 2006 and March 2008, patients at the Denver Metro Health Clinic were routinely asked about sexual encounters with internet partners. This retrospective case-control study was limited to patients who tested for Ct/GC at their visit. Analyses were stratified by sexual orientation to account for differences in baseline risk behaviours.

Of 14 955 patients with a valid Ct/GC test result, 2802 (19%) were infected with Ct/GC. Stratified by sexual orientation, the prevalence of Ct/GC infection was 17% for men who have sex with men (MSM), 21% for men who have sex with women (MSW) and 16% for women. A total of 339 (23%) MSM, 192 (3%) MSW and 98 (2%) women reported having a sexual encounter with a person they met on the internet in the past 4 months. The estimates of the association between recent internet sex partner and current Ct/GC infection were not significant for MSM (risk ratio (RR): 1.12, 95% confidence interval (CI): 0.84 to 1.49) and women (RR: 0.81, 95% CI 0.45 to 1.48). However, the association appeared to be significantly protective among MSW (RR: 0.66, 95% CI 0.44 to 0.98).

Sexual encounters with internet partners did not appear to be associated with increased risk of current Ct/GC infection among people seeking care at a sexual health clinic. Seeking sexual partners on the internet is a complex behaviour and its implications for STI/HIV infection are not fully understood.