To people who grew up before the internet, the debate about whether Craigslist should be allowed to post “erotic services” must seem bizarre. But meeting people online, whether for romance, friendship, collegiality, or anonymous sex is becoming not only common, but has lost its novelty. This isn’t going anywhere. The most compelling argument I’ve heard for asking Craigslist to abandon its lucrative paid sex ads is that it helps perpetuate an oppressive and violent sex trade, one that essentially enslaves women and turns them into chattel for the profit of others. That’s pretty damned compelling.
But should those of us who care about public health focus only on the “sex work” section of online bulletin boards? People meeting not only for romance but also for consensual, sometimes anonymous sex has become increasingly common. Like the bath houses of the 1970s, could online sex encounters encourage the risk of sexually transmitted infections?
Data from before the late 1990s are hard to find, since broadband internet services were not widely available. In 2000, a study of a small syphilis outbreak among men who have sex with men (MSM) found that the men who had syphilis were much more likely to have met partners in an online chat room than men without syphilis. This made notification of contacts (for control of the outbreak) more difficult. Of note, when public health authorities launched an informational campaign about the phenomenon, gay online chat rooms were flooded with anti-gay hate messages, perhaps interfering with effective outreach.
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