Gay Skintimates of the Rumor Mill have long referred to AOL as the "Gay Home Shopping Network," and Steve Case is known to have credited AOL's survival at critical junctures to heavy gay use of the online service. "Thank God for the gays and lesbians," he once reportedly said.
Steve Case is undoubtedly still grateful for the gays and lesbians, but the AOL Time Warner chairman can't be too happy about a new flare-up in the long-standing battle between the company and San Francisco's health department over a suspected link between AOL chat rooms and an explosive rise in the number of syphilis cases among gay men in the city.
The current contretemps has generated a maelstrom of confusion, with a local AIDS activist, a U.S. House of Representatives staffer, a local health official, and an AOL vice president all getting into the melee and offering conflicting versions of events.
The controversy first arose two years ago after gay portal PlanetOut agreed to spearhead an outreach effort aimed at educating denizens of AOL's "sanfranciscom4m" chat rooms about the heightened risk of syphilis among men meeting there.
The link between the AOL chat rooms and the syphilis outbreak was the subject of a July 2000 article published in the Journal of the American Medical Association, which reported that gay men who had syphilis in San Francisco were eight to nine times more likely to have met a recent partner in the AOL chat rooms than elsewhere.
Two years later, the local syphilis rate among gay men continues to skyrocket, with AOL's chat rooms linked to between a fifth and a third of reported cases, according to Dr. Jeff Klausner, director of San Francisco's STD Prevention and Control Services.
In 1999, according to the doctor, nine of the 29 syphilis cases in gay men were linked to AOL's sanfranciscom4m chat rooms. In 2000, it was 10 of 47 cases. So far this year, the number is 15 out of 87.
While San Francisco's syphilis rate is spiking among gay men, the nationwide rate is heading south.
After heavily lobbying AOL to warn SFM4M chatters about the problem, Klausner told the Rumor Mill he'd finally succeeded in securing a commitment from AOL's vice president of corporate relations, Richard Socarides, to post notices in the chat rooms.
But AOL denies that Socarides made any such commitment.
"He said we're working with the CDC (Centers for Disease Control) to educate our members about health issues including STDs, and we've been doing so for more than a year," said an AOL representative. "We have not disclosed how that campaign is going to work yet."
That noncommittal commitment has Klausner in a fit.
"It amazes me that AOL still denies any associated risk to its members of meeting new sexual partners in the AOL SFM4M chat rooms," Klausner fumed to the Rumor Mill. "Richard clearly stated that AOL would inform members in appropriate places of this risk...The fact that AOL has been working with CDC to educate its members about health issues is neither here nor there. What we are asking for is not general education but specifically to inform members who use the AOL SFM4M chat rooms that persons who have met recent sexual partners (there) have acquired syphilis."
Could San Francisco really pin the syphilis explosion to AOL chat rooms? After all, people who meet on AOL also meet for sex all over town, and all over the Internet, for that matter.
"No," Klausner replied. "Many more syphilis cases in San Francisco meet partners on AOL SFM4M than on Gay.com, MSM4sex.com or many other sites or other venues."
Klausner, CDC representatives and health officials in AOL's home state of Virginia say the AOL chat room-syphilis link is unique to San Francisco, as far as they know.
The U.S. House of Representatives, now engaged in more pressing bacteriological matters, became involved in the fracas when Roland Foster, staff member on the Government Reform Committee's Subcommittee on Criminal Justice, Drug Policy and Human Resources, fired off a blistering e-mail to the CDC inquiring whether Klausner had tried to get Virginia's health department to shut down AOL chat rooms.
"It has come to my attention that Klausner has made numerous calls to the Virginia Health Department over the past six weeks demanding that Virginia act to close a number of online chat rooms," Foster wrote the CDC. "It is my understanding that Dr. Klausner blamed Virginia for a recent trend of HIV infections in the City acquired from sex partners who met online. According to Dr. Klausner's accusations, a 'majority' of new HIV cases in San Francisco are linked to America Online (AOL) chat rooms."
Klausner told the Rumor Mill he hadn't tried to get AOL or the state of Virginia to shut any chat rooms--a move he considered counterproductive for education and outreach efforts--and that he'd found no special link between AOL and any spike in HIV cases. He suggested that Foster had been the recipient of misinformation spread by a San Francisco AIDS activist known for confusing journalists and public officials.
Casey Riley, director of the division of STD/HIV and viral hepatitis at the Virginia department of pubic health, said San Francisco had asked his department to "see what we could do to get AOL to put educational information messages in their chat room. We were under the impression that AOL was already doing this."
Meanwhile, the CDC said it was planning a fall meeting with Internet service providers and telecom types to address STD prevention.
A CDC representative added that the agency was researching the link between chat rooms and STDs, and that preliminary evidence showed that people who searched for sex partners online reported more sex partners and a higher rate of STDs.
Klausner said his request of AOL was nothing out of the ordinary.
"This is run-of-the-mill public health," he said. "We ask businesses whose services have been implicated in disease transmission or facilitation of disease transmission to inform their patrons of the risk."