Public health officials are considering filing a lawsuit to force Internet service provider America Online and some Web sites to warn members about outbreaks of sexually transmitted diseases among the men who have sex with men who use their services to find sex partners, Wired News reports. A report released last month found that 44% of recently diagnosed syphilis cases in San Francisco were linked to the Internet, compared with 13% in 2000. Similar statistics are not available for HIV/AIDS because the disease has a longer incubation period, but many men diagnosed with syphilis are HIV-positive, Wired News reports. Health officials more than two years ago began requesting that some Web sites warn users about STDs after they detected an increase in syphilis cases nationwide (Dotinga, Wired News, 1/22). In 1999, when San Francisco officials traced a rise in the number of syphilis cases to seven men who had used an AOL chat room to meet partners, Dr. Jeffrey Klausner, head of the city's STD control division, tried to use the Internet to alert potential partners to the risk and urge them to be tested. He asked AOL to post syphilis warnings in its San Francisco chat rooms but was turned down. Instead, the company offered his staff free AOL accounts so they could log in and disseminate information about the diseases. According to Klausner, fewer than half of the seven men's partners were notified and tested, illustrating difficulties of practicing prevention and partner notification with people who meet over the Internet. Many Internet encounters are often anonymous, with partners only knowing each other by their screen names, which can change daily, and many Internet service providers will not release the names of customers without a court order (Kaiser Daily HIV/AIDS Report, 7/26/02).

Legal Action?
Klausner said that he would like managers of chat rooms to inform members about syphilis outbreaks connected to specific chat rooms, according to Wired News. However, Klausner said he would be content with other sexual health education measures. Some Web sites currently post links, messages and banner advertisements about safer sex, and other sites offer discounted advertising for safer sex messages. AOL still provides free accounts for safer-sex counselors and last year briefly posted public service announcements. However, the company now refuses to post announcements or banner ads in private chat rooms. AOL spokesperson Andrew Weinstein said that the company lacks the technical ability to place ads targeting specific chat rooms. In addition, Weinstein says that AOL wishes to protect users' privacy, adding, "I don't think any of our members would want to track who goes into what chat rooms." Deb Levine, executive director of Internet Sexuality Information Services, said that AOL should target users with free banner ads, according to Wired News. Klausner said that public health officials may be able to sue AOL under the same laws that require alcohol companies to put warning labels on their bottles. However, Charles Tobin, a media attorney, said that there is "no legal mechanism to force an industry like the Internet to post any kind of message" and that Web sites are not responsible for monitoring the content of their chat rooms. In addition, even if health advocates are successful in forcing Web sites to cooperate, it is unclear whether such prevention efforts are effective, Wired News reports. Links to outside Web sites can be ignored and safer-sex counselors in chat rooms are reportedly kicked out by other users on a "regular basis," according to Wired News (Wired News, 1/22).

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