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Theyre clearly facilitating the transmission of STDs and new HIV infections, said Dr. Klausner and colleagues hope to recruit attorneys to push their cause nationally and put the brakes on a growing number of Internet-related syphilis outbreaks. But AOL, which says its acting responsibly, may be able to beat back any challenge with a handy weapon known as the First Amendment. While the threats of legal action are new, the battle between public health officials and AOL is not. Theyve been butting heads for more than two years, ever since researchers began detecting increases in syphilis cases nationwide. To the relief of doctors, syphilis hasnt developed immunity to antibiotics, and penicillin easily wipes out the disease in its early stages. The number of cases nationwide - 6,862 in 2002 - remains very small, far from the peak of 106,000 in 1947. But the increase in cases among gays has torpedoed national plans to virtually eliminate the disease in the United States by the middle of the decade. Experts fear that the outbreaks reflect growing sexual carelessness among gay males - thanks, perhaps, to condom fatigue - and could be an early warning sign of a worsening AIDS epidemic. It didnt take long for experts to trace the syphilis outbreaks to online chat rooms where gay men meet and set up sexual encounters outside the traditional venues of bars, bathhouses and sex clubs. While heterosexuals use the Internet to find sex, too, chat rooms are more popular among gay and bisexual men, said Dr. Valdiserri, a deputy director with the Centers for Disease Control and Prevention .
At one point late Monday evening, the number of member-created chat rooms topped 500, with almost all geared toward gay men, or M4M in AOL-speak. Many with names like delawarem4m2 and tampam4m3 reached the maximum of 36 members each, while solo members waited for drop-ins at Waynsboro VA M4M and Sandusky m4Fun. According to a report released last month, 44 percent of recently diagnosed syphilis cases in San Francisco were linked to the Internet, compared with just 13 percent in 2000. No one knows if chat rooms are contributing to the AIDS epidemic because it can take months or years for people to realize theyre infected, but many men diagnosed with syphilis are HIV-positive. Ideally, Klausner said, chat-room managers would directly notify members about syphilis outbreaks connected to their chat rooms. Failing that, Klausner said hes content to see websites support other ways to educate visitors about sexual health. In San Francisco, visitors to the men seeking men section of craigslist must click past a link to a safer-sex forum and a brief message about sexual health.
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