Objective:
To characterize the California trends of MSM syphilis cases reporting the Internet and use of this data in HIV/STD prevention efforts.

Methods:
Infectious syphilis cases are interviewed by disease intervention specialists (DIS) for patient/partner management and surveillance purposes. DIS investigate sex partners of cases for counseling, testing, and treatment. Since 1999, interview data are transcribed onto standardized case report forms to capture patient demographic and risk behavior information. These data include: venues where cases report meeting sex partners, drug use, and HIV serostatus.

Results:
From 2001 through the first half of 2003, 84.4% of 2276 primary and secondary (P&S) cases were MSM. Among MSM, 522 P&S cases were diagnosed in the first half of 2003, a 246% increase from the first half of 2001 (p<0.0001). Among interviewed MSM, 37% reported meeting partners through the Internet in the first half of 2003, an increase from 12% in the first half of 2001 (p<0.0001). MSM patients reporting the Internet had higher numbers of period sex partners than those who did not for primary (9.7 vs 6.5, p<0.0001) and secondary (18.7 vs 10.6, p<0.0001) stages. A greater number of non-locatable sex partners were from patients reporting the Internet than those who did not for primary (8.2 vs 5.5, p=0.0001) and secondary (16.4 vs 9.6, p<0.0001) stages.

Conclusions:
The Internet is an emerging venue associated with a substantial and increasing proportion of MSM syphilis patients in California. With high numbers of non-locatable sex partners from MSM cases reporting the Internet, traditional contact investigation alone is not an effective syphilis control measure

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