San Francisco Examiner - August 23, 1999
Ilene Lelchuk of the Examiner Staff

In the virtual world of chat rooms, participants are known only by their screen personas, leaving the San Francisco Department of Health with no names, faces or phone numbers to find the men who might have been exposed to the sexually transmitted disease.

"Partners range anywhere from seven to 47 (men)" who might have dated after meeting in the chat room, said Jeffrey Klausner, director of the Department of Public Health's sexually transmitted diseases division.

The seven San Francisco men who tested positive for syphilis during the past four weeks traced their last sexual contacts to men they met in AOL's SFM4M (San Francisco Men 4 Men) chat room, Klausner said.

Although the number of syphilis cases traced to the chat room is small so far, the implications are big. Chat rooms are fast becoming the singles bars of the 21st century, and chances for exposure can grow unless Klausner gets the word out.

A syphilis outbreak could have a major impact on San Francisco's gay community because the disease causes genital sores, which increase the victim's vulnerability to contracting and spreading HIV.

"STD control is HIV prevention," Klausner said.

San Francisco experienced the nation's highest rate of syphilis infection in the late 1970s and early 1980s, the same time that The City saw its highest number of HIV infections, he said.

Now cases of syphilis - a bacterial infection easily treated with antibiotics when detected early - are at an all-time national low, and Klausner wants to help keep it that way. In fact, U.S. health officials have targeted the disease for elimination.

Klausner was stumped at first when AOL, following its strict privacy policy, declined to release information about its members who visit the chat room. But then AOL put Klausner in touch with San Francisco-based PlanetOut, the largest online service for gays, lesbians and bisexuals.

PlanetOut employees spent the past two weeks visiting the chat room and warning users about the outbreak. Their messages urge participants to take syphilis tests and to practice safe sex.

Tom Rielly, founder of Planet/Out, said letters from his organization might be better received than warnings issued by a government entity like the Health Department.

"We felt we could write that letter with more credibility," he said.

Rielly stressed that chat room anonymity will continue to be protected. "We have never had the names of the people exposed, and AOL did not disclose information about its members," he said.

Health officials don't know yet how well their first cyberspace campaign is working.

This new strategy for curbing syphilis is a far cry from the traditional methods of the Health Department. At San Francisco's sex clubs, for example, health officials frequently distribute literature and offer free disease screenings and condoms.

But Klausner said he is poised for a long-term Internet campaign and a continued partnership with PlanetOut.

Online dating has exploded in popularity in the past two years since AOL and other Internet service providers adopted flat fees instead of per-minute rates.

"In 1994 and 1995, AOL was like a small town," said John Sharp, an associate community producer for PlanetOut. "But since the flat rate came out, AOL is like New York City. You can get lost. There are some dirty streets and some clean streets. And you have to be careful because (you are dealing with) real people."

Working on the Web has been an intriguing experience for Klausner. "We've learned that Internet contacts are an important sexual network," he said. With the proliferation of antibiotics and safe sex campaigns, syphilis cases declined nationwide in the 1990s, and the national Centers for Disease Control and Prevention is launching a campaign with state and county health officials to eliminate the disease through education.

Syphilis rates in the United States declined 84 percent between 1990 - the peak of the most recent epidemic - and 1997, when 8,551 cases of primary and secondary stages of syphilis were reported, according to the CDC.

In San Francisco, 17 cases of recent infection were reported during the first six months of 1999, a 33 percent drop from the 25 cases reported during the same period in 1998, Klausner said.

Syphilis is thought to have first appeared in the 16th century and was considered a scourge by the Victorian era. Syphilis is caused by the bacterium Treponema pallidum and is transmited through broken skin or mucous membranes. Left untreated, the potentially deadly infection causes sores and rashes, and then brain damage and heart disease.

Free and confidential screenings are available Monday through Friday at the City Clinic, 356 Seventh St., in downtown San Francisco. For more information, contact Klausner at (415) 554-8486. Or visit PlanetOut's Web site, www.planetout.com.
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