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Characteristics of MSM Syphilis Cases using the Internet to Seek Male Sex Partners, California, 2001 - 2003 Terrence Q. Lo 1, MPH Michael C. Samuel 1 DrPH,

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Presentation on theme: "Characteristics of MSM Syphilis Cases using the Internet to Seek Male Sex Partners, California, 2001 - 2003 Terrence Q. Lo 1, MPH Michael C. Samuel 1 DrPH,"— Presentation transcript:

1 Characteristics of MSM Syphilis Cases using the Internet to Seek Male Sex Partners, California, Terrence Q. Lo 1, MPH Michael C. Samuel 1 DrPH, Charlotte Kent 2, Jeff Klausner 2, Peter Kerndt 3, Stewart Coulter 1, Greg Mehlhaff 1, Dan Wohlfeiler 1, Gail Bolan 1 1 California Department of Health Services, STD Control Branch 2 San Francisco Department of Public Health, STD Prevention and Control Services 3 Los Angeles County Public Health Department, STD Program National STD Conference Philadelphia, PA March 11, 2004

2 Syphilis is epidemic among gay and other men who have sex with men (MSM) in California 85% of primary and secondary syphilis cases were among MSM (California, 2001 – 2003) Traditional syphilis control measures focus on notification, testing, and treatment of locatable sex partners Background

3 Primary & Secondary Syphilis Cases by Gender, California, ALL MALE FEMALE MSM 3/04 Provisional Data - CA DHS STD Control Branch

4 Operational Disease intervention specialists (DIS) interview infectious syphilis cases for patient/partner management and surveillance purposes DIS attempt to contact sex partners Non-locatable sex partners include: -anonymous partners -partners known but not disclosed to health department staff Methods

5 Venue information Venues for meeting partners include: The Internet is a virtual venue; includes chat rooms, online personal ads, and sex parties posted online INTERNET Sex clubs Bathhouses Bars/clubs Motels Parks Streets Other venues (resorts, circuit parties, private parties, adult bookstores/theaters, telephone chat lines, gyms)

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10 Results 3/04 Provisional Data - CA DHS STD Control Branch 76% of P&S MSM cases reported any venues from 2001 – 2003 Top 4 -Bars/clubs (31%) -INTERNET (28%) -Bathhouses (20%) -Sex clubs (9%) 67% of P&S MSM cases reported at least one of the Top 4 1.3% (5 / 375) heterosexual syphilis cases reported the Internet

11 % of MSM Syphilis Cases Reporting Meeting Partners by Venue INTERNET Bars/Clubs Bathhouses Sex clubs 3/04 Provisional Data - CA DHS STD Control Branch Trend test for INTERNET, p < Bathhouses and sex clubs combined, p =.04

12 % of Cases Reporting Internet Only, Commercial Sex Venues (CSV*) Only, Internet and CSV, or Internet and Bars/Clubs INTERNET only CSV* only Internet and Bars/Clubs Internet and CSV* Trend test for: Internet only, p < CSV only, p = Internet and CSV, p = 0.01 Internet and Bars/Clubs, p=0.10 3/04 Provisional Data - CA DHS STD Control Branch *Includes bathhouses and sex clubs

13 % of MSM Syphilis Cases Reporting Meeting Partners through the INTERNET by HIV Status Trend test for HIV+ (p < ) and HIV- (p < 0.001) significant Positive Negative 3/04 Provisional Data - CA DHS STD Control Branch

14 % of MSM Syphilis Cases Reporting the INTERNET by Race and Age Group, 2001 – 2003 White Latino Black Trend test for: Whites, p = 0.05 Asians, p = Latinos, p = 0.38 Blacks, p = /04 Provisional Data - CA DHS STD Control Branch Asian

15 Reported Internet Did not report Internet Male and female partners 3%8% Methamphetamine use28% 15% Anonymous sex partners72% 59% College graduate or advanced degree47%35% p < for all Characteristics of MSM Cases Reporting the INTERNET vs. those that did not, 2001 – 2003 Among cases that… 3/04 Provisional Data - CA DHS STD Control Branch

16 Mean Number and Non-locatable Sex Partners by Venue, MSM Primary 1 Syphilis Cases 1 Interview period = 3 months *Includes bathhouses and sex clubs 3/04 Provisional Data - CA DHS STD Control Branch

17 % of Sex Partners that were Non-locatable by Venue, MSM Primary 1 Syphilis Cases 1 Interview period = 3 months *Includes bathhouses and sex clubs 3/04 Provisional Data - CA DHS STD Control Branch

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21 Conclusions Among California MSM P&S syphilis cases: The Internet has become a commonly reported venue Cases using only the Internet have substantially increased >80% of partners among cases reporting the Internet were non-locatable to health department Because a significant number of partners are non- locatable, traditional syphilis control measures alone are not an effective control strategy

22 Future research: 1.HIV sero-sorting and the Internet 2.Percentage of MSM without syphilis utilizing the Internet 3.Characteristics of MSM using the INTERNET only 4.Proportion of non-locatable partners truly anonymous versus those who could be located through other strategies Comprehensive syphilis control strategies should incorporate appropriate Internet-based interventions Recommendation

23 Terrence Q. Lo Epidemiologist CA Department of Health Services STD Control Branch (510)

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25 Number of MSM P&S Syphilis Cases by Region and Year 2/04 Provisional Data - CA DHS STD Control Branch

26 % of MSM Syphilis Cases Reporting Meeting Partners through the INTERNET by Region San Francisco Rest of California Los Angeles 3/2004 Provisional Data - CA DHS STD Control Branch

27 % of MSM Syphilis Cases Reporting Meeting Partners by Venue INTERNET Bars/Clubs Bathhouses Sex clubs 1/2004 Provisional Data - CA DHS STD Control Branch Trend test for INTERNET, p <

28 % of Cases Reporting Only Internet, Only Commercial Sex Venues (CSV*), Internet and CSV, or Internet and Bars/Clubs INTERNET only CSV* only Internet and Bars/Clubs Internet and CSV* *Includes bathhouses and sex clubs Trend test for: Internet only, p < CSV only, p = Internet and CSV, p = 0.02 Internet and Bars/Clubs, p = /2004 Provisional Data - CA DHS STD Control Branch

29 % of MSM Syphilis Cases Reporting Meeting Partners through the INTERNET by Region San Francisco Rest of California Los Angeles 1/2004 Provisional Data - CA DHS STD Control Branch

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