The Internet and HIV study: design and methods

Background: The Internet provides a new meeting ground, especially for gay men, that did not exist in the early 1990s. Several studies have found increased levels of high risk sexual behaviour and sexually transmissible infections (STI) among gay men who seek sex on the Internet, although the underlying processes are not fully understood. Research funded by the UK Medical Research Council ( 2002 - 2004) provided the opportunity to consider whether the Internet represents a new sexual risk environment for gay and bisexual men living in London. Methods: The objectives of the Internet and HIV study are to: ( i) measure the extent to which gay men living in London seek sexual partners on the Internet; ( ii) compare the characteristics of London gay men who do and do not seek sex on the Internet; ( iii) examine whether sex with Internet-partners is less safe than with other sexual partners; (iv) compare use of the Internet with other venues where men meet sexual partners; ( v) establish whether gay men use the Internet to actively seek partners for unprotected anal intercourse; ( vi) determine the potential for using the Internet for HIV prevention. These objectives have been explored using quantitative and qualitative research methods in four samples of London gay men recruited and interviewed both online and offline. The four samples were: ( i) gay men recruited through Internet chat rooms and profiles; ( ii) HIV positive gay men attending an NHS hospital outpatients clinic; ( iii) gay men seeking an HIV test in an NHS HIV testing or sexual health clinic; ( iv) gay men recruited in the community. Results: Quantitative data were collected by means of confidential, anonymous self-administered questionnaires (n> 4000) completed on-line by the Internet sample. Qualitative data were collected by means of one-to-one interviews ( n = 128) conducted either face-to-face or on-line. Conclusion: The strength of the Internet and HIV study is its methodological plurality, drawing on both qualitative and quantitative research among online and offline samples, as well as taking advantage of recent advances in web survey design. The study's findings will help us better understand the role of the Internet in relation to gay men's sexual practice.