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No password was needed, and the site was available to all chatters within the chat room who saw the Web site address. The Web site hosting the brief assessment was available up to 1 h after the final message was sent to the public chat room. Chatter profiles are online responses to close- and open-ended standardized items that many chatters choose to complete and are accessible to all chatters within the chat room. The educators were guided by the CBPR partnership to create titillating profiles to spark interest for the target community while accurately representing their roles in the chat room.

SPSS Descriptive analyses were performed to examine overall prevalence, group prevalence and distribution shape. Demographic and risk data were then analyzed in bivariate analyses using chi-square and Fisher's exact tests for categorical variables, and t -tests for continuous variables to compare men by group.

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Risks also were analyzed in a multivariable logistic regression model that adjusted for demographic differences as covariates. Of the male participants, the mean age was A third of participants All participants reported having sex with other men within the past 2 years. Selected characteristics of participants by recruitment group are presented in Table I. Table II presents risk behavior comparisons for the total sample and by recruitment group.

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More than three-fourths More than one-third Comparison of risk of participants by recruitment strategy: bivariate analysis. One-third More than one-quarter Use of one of the common drugs to enhance sexual satisfaction was reported by Chatters who participated in the HIV prevention outreach intervention were ificantly more likely to report using poppers during the past 30 days Passively recruited participants had an increased odds of reporting: higher mean of hours spent in online chat rooms during the past 7 days; oral sex and receptive anal intercourse with multiple partners in the past 3 months; inconsistent condom use during anal intercourse with a man met online during the past 3 months; ever having had an STD; being HIV seropositive; illicit drug use during the past 30 days and use of drugs to enhance sexual satisfaction during the past 30 days.

Comparison of risk of participants by recruitment strategy: multivariable logistic regression analysis. Several findings from this analysis deserve highlighting.

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First, the overall analysis included a majority of non-White participants. Most often, participants in online research targeting MSM tend to be White [ 4101325—28 ]. Furthermore, populations most at risk for HIV appear to be early adopters of the Internet for both sexual and non-sexual communication [ 21 ]; thus, use among MSM may not reflect use suggested by aggregate trends.

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Our recruitment of a majority of Black and African American MSM runs counter to US population trends; however, White chatters were more likely to participate in the online assessment if they were actively recruited, rising questions about race and bias in access to HIV prevention interventions. They may not have trusted the anonymity of the assessment when actively recruited. An important consideration is that chat room-based interventions may further reinforce inequalities in health outcomes if they reach men who are more likely to participate.

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Sexual orientation also was associated with recruitment strategy. Participants who self-identified as bisexual were less likely to participate in the assessment when actively recruited. Bisexual chatters may not have trusted the anonymity of the assessment when actively recruited; they may have worried about female partners discovering their same-sex behavior. Furthermore, because research has identified stigma attached to bisexuality [ 38—40 ], these men may have had a level of perceived discrimination from the gay community, either online or in person, which in turn discouraged their participation in active recruitment.

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Besides the demographic differences identified by recruitment strategy, risk also differed by recruitment strategy. Of 18 risks examined, passively recruited participants were more likely than the actively recruited participants to report 10 of them.

Actively recruited participants were more likely to report none of the 18 risks. Most notably, passively recruited participants had over double the odds of reporting oral sex and receptive anal sex with multiple partners during the past 3 months, and nearly double the odds of inconsistent condom use during anal sex with men met online, during the past 3 months. In addition to sexual risk and history of STD and HIV infection, drug use differed between the two recruitment groups.

Passively recruited participants were at increased odds of reporting illicit drug use, methamphetamine use and ecstasy use during the past 30 days.

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These participants also were at increased odds of reporting use of drugs to enhance sexual satisfaction. These findings are important given the links of use of these substances, including methamphetamines, ecstasy and drugs to enhance sexual satisfaction, with sexual risk behavior [ 41—46 ]. The implications of this analysis fall into three : i the sexual risks of MSM in Internet chat rooms, ii the findings in terms of chat room-based data collection and iii the findings in terms of chat room-based HIV prevention outreach interventions.

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As described in this analysis and in the literature on the epidemiology and behaviors of MSM who use Internet chat rooms for social and sexual networkingchatters were at risk for HIV and other STDs. Further research is needed to understand and document social and sexual networks within online communities; to explore ways to reach the various online subgroups, including those that may be harder to reach for outreach and intervention e. How men negotiate risk with partners met online was not explored in this study; however, risk-reduction techniques such as engaging in oral as opposed to anal sex may occur between men as they negotiate sex online or after meeting in person.

This analysis suggested that active recruitment led to a sample of online chatters who were at risk but were not at the greatest risk within the chat room. For chat room-based data collection efforts, using general messages as opposed to targeted messages to the public chat room may be more effective in collecting data on the higher risk chatters. Further research is necessary to document and understand the demographic, psychological and sociocultural characteristics of participants using different recruitment strategies.

It also remains unclear how participants recruited using active versus passive recruitment in chat rooms might differ from participants recruited using other online modalities such as banner advertisements. Furthermore, we have no information how chatters who did not participate in either recruitment strategies differed.

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Although research has begun to compare online to traditional samples of MSM this research is nascent and may evolve as Internet technology changescomparisons of online samples by recruitment strategies are rare. Further research is needed to understand more about these chatters and to determine what types of HIV prevention outreach interventions would reach them, particularly racial and ethnic minority MSM who tend to carry a disproportionate infection burden and have worse health outcomes. First, we were unable to calculate a response rate for each recruitment strategy because of the unknown of chatters potential participants who read the general public chat room messages but chose not to reply or participate.

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Comparing the of chatters in the chat room to the who completed the assessment would not be accurate because chatters engaged in private chats may not attend to messages in the public room; thus, the denominator may be artificially high. At Project Silk, vogue is a favorite pastime.

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