Internet dating does not increase STI risk

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Finding sex through the internet does not increase the risk of catching the two most common sexually transmitted infections, a US survey published in Sexually Transmitted Infections has found. Indeed, in the case of heterosexual men, meeting partners through the internet was associated with a lower risk of sexually transmitted infections compared with other ways of meeting.

Gay men who met someone through the internet in the last four months were slightly more likely, and women slightly less likely, to be diagnosed with a sexually transmitted infection, bit in neither case were these figures statistically significant and could have been a chance finding. However heterosexual men who had had at least one internet date in the last four months were around 60% less likely to have a sexually transmitted infection than men who hadn’t, and this was statistically significant.

The study authors note that some other surveys have found that internet dating is strongly associated with the risk of sexually transmitted infections and HIV. However, they say, many surveys measured risk behaviour such as non-use of condoms rather than incidence of sexually transmitted infections. They also compared dissimilar populations: if people who make contact through the internet are generally more interested in sex and have more partners, then surveys are merely comparing rates of sexually transmitted infections between people who have a lot of sex and people who have less, rather than finding a specific risk associated with online contacts.

Glossary

statistical significance

Statistical tests are used to judge whether the results of a study could be due to chance and would not be confirmed if the study was repeated. If result is probably not due to chance, the results are ‘statistically significant’. 

chlamydia

Chlamydia is a common sexually transmitted infection, caused by bacteria called Chlamydia trachomatis. Women can get chlamydia in the cervix, rectum, or throat. Men can get chlamydia in the urethra (inside the penis), rectum, or throat. Chlamydia is treated with antibiotics.

risky behaviour

In HIV, refers to any behaviour or action that increases an individual’s probability of acquiring or transmitting HIV, such as having unprotected sex, having multiple partners or sharing drug injection equipment.

safer sex

Sex in which the risk of HIV and STI transmission is reduced or is minimal. Describing this as ‘safer’ rather than ‘safe’ sex reflects the fact that some safer sex practices do not completely eliminate transmission risks. In the past, ‘safer sex’ primarily referred to the use of condoms during penetrative sex, as well as being sexual in non-penetrative ways. Modern definitions should also include the use of PrEP and the HIV-positive partner having an undetectable viral load. However, some people do continue to use the term as a synonym for condom use.

The study involved nearly 15,000 patients who had attended a sexually transmitted infections clinic in Denver, Colorado, for check-ups and who could therefore be assumed to be roughly similar in sexual behaviour and demographics. It then compared internet dating rates between the 2800 patients (nearly one in five) who were diagnosed with gonorrhoea or chlamydia, and the remainder who were not.

It asked patients whether they had had sex with someone met through the internet in the last four months, in the last year, more than a year ago, or never and also related sexually transmitted infections and internet-dating rates to patients’ gender, ethnicity, sexuality, age, HIV status and number of partners.

Internet dating was more common in gay men than heterosexuals: nearly a quarter of gay men (23%) had had an internet meet in the last four months compared with 3% of heterosexual men and 2% of women. But since only one in ten of the clinic population was a gay man, nearly as many heterosexuals (290) as gay men (339) had had a recent internet meet.

Internet dating was, as predicted, associated with having more partners. Across all sexual categories, internet daters were 21 to 23% more likely to have had more than one partner in the last four months than non-users.

Internet users were younger on average, and among heterosexuals, though not gay men, there was an interesting association with ethnicity: women internet daters were significantly more likely to be white and straight male daters significantly more likely to be black.

Straight men were slightly more likely to be diagnosed with a sexually transmitted infection than women or gay men; men were more likely to have gonorrhoea and women more likely to have chlamydia.

Amongst gay men, internet users were 50% more likely to have HIV; the HIV-infection rate among internet users was 12% compared to 8% for non-users. There were only four cases of HIV among heterosexuals diagnosed with a sexually transmitted infections (three women, one man); rates in people without a sexually transmitted infections aren’t known because many straight patients had not been tested for HIV.

As detailed above, gay men who had had an internet date in the last four months were 12% more likely to have a sexually transmitted infection, women 29% less likely, and straight men 42% less likely, with the figure reaching statistical significance in straight men.

When the figures were adjusted for partner numbers and ethnicity, straight men who had internet dates were still a third less likely to have a sexually transmitted infections than internet non-daters; in other words, the fact that internet daters had more partners did not make a difference, and there appears to be a genuine association between internet dating and a somewhat lower risk of sexually transmitted infections.

The authors point out that they only asked a single question about internet dating. Their study therefore makes no distinction between gay ‘party boys’ and straight ‘swingers’ who may use the internet for multiple sex contacts, and people who are seeking longer-term relationships that way.

Distinguishing these two populations might have found widely different sexually transmitted infections rates and risks associated with internet contact. However, the fact that sexually transmitted infection risk was somewhat lower in heterosexuals may show that the internet is allowing some safer sex negotiations, the resaerchers add.

References

Al-Tayyib AA et al. Finding sex partners on the internet: what is the risk for sexually transmitted infections? Sex Transm Infec (online publication), 19 December 2008. doi:10.1136/sti.2008.032631