Reported sexually transmitted infections in Swedish Internet-using men and women.

Although the Internet has become a forum for making sexual contacts, and has been associated with increased sexually transmitted infection (STI) transmission, we have little information of history of STIs in Internet-based samples. The Internet behaviours that are associated with STI acquisition are poorly understood. We analysed STI histories reported by 904 Swedish men and 931 Swedish women who responded to an Internet-based survey on sexual behaviour in 2002: 16.6% of men and 22.5% of women reported a lifetime history of STIs, with Chlamydia being the most common for both genders. 3% of men and 5% of women who reported an STI, indicated that they had had more than one. Sources of the STI, where known, were Internet-acquired partners in only 3% of cases. There were no differences between men and women with or without an STI history regarding the kind of online sexual activities they engaged in, how they found sexual material online, and the reasons they engage in sexual activities. These rates are similar to those reported in a national random study of sexuality in Sweden. Contrary to prior research, these results suggest no relationship between STI and specific Internet characteristics usage patterns. These data suggest that the Internet is not yet a major source of STIs in Swedish men and women. Given these STI histories, the Internet may be a useful medium to include in STI prevention efforts.

Differences between Internet samples and conventional samples of men who have sex with men: implications for research and HIV interventions.

The Internet is becoming a new erotic oasis for obtaining sex online or in person. We reviewed the literature on cybersex and compared differences in data from samples of homosexually active men obtained on identical questionnaires from a conventional written questionnaire, distributed through the mailing and contact lists of a large national gay organization in Sweden, and through the same organization's website and chat room. A total of 716 written questionnaires and 678 Internet questionnaires were obtained. The Internet sample was younger, more likely to live in small towns or cities, live with parents or a girlfriend, and have lower formal education. They are less likely to have previous sexual experience solely with other men (one in three of the Internet sample vs. 1 in 14 of the written sample defined themselves as bisexual) and more likely to visit erotic oases such as bathhouses, video clubs and erotic movie houses. They also visited Internet chat rooms more frequently (86% of the Internet sample vs. 50% of the written sample). One third of the Internet sample wanted the opportunity to talk with an expert about HIV compared with a quarter of the written sample. Sexual practices between the two samples were generally similar, although the Internet sample reported significantly less body contact, kissing, hugging, mutual masturbation, and more condom use for anal intercourse with steady partners. Over four times as many of the Internet samples reported sex with women in the past year as the written sample. These data indicate that Internet data collection is feasible and that this mode of data collection, despite the nonrandom and self-selected nature of both types of samples, is likely to be more significantly oriented toward the young, geographically more isolated, and more behaviorally and self-identified bisexual respondent than conventionally distributed written questionnaires.

Psycho-social aspects of HIV testing--the Swedish case.

Almost 10% of the Swedish population--more than 800,000 people--have been tested for HIV antibody to date. More people in Sweden have been tested (per million inhabitants) than in any other European country. The number of people found to be HIV positive has steadily decreased since 1985, from approximately 45 to 25 a month. Several reasons for this decrease have been suggested. On the one hand, preventive measures taken by the government may have succeeded. On the other hand, the large government backed information campaign has had as its target group 'the general population' and not the group who until now have been most at risk for HIV infection. Consequently, there may be many more people 'out there' carrying the virus than is shown in the statistics. Furthermore, there is evidence that the acceptance rates for testing among homosexual men have been steadily decreasing since 1985. This may be the result of unsatisfactory pre- and post-test counselling as well as the lack of sufficient psycho-social support offered to persons who test positive to HIV. This paper offers a critical analysis of Swedish AIDS policy with special emphasis on the psycho-social aspects of HIV-testing.