August 25, 1999
Privacy Issues Raised in Syphilis Cases Linked to San Francisco Chat Room
By EVELYN NIEVES
AN FRANCISCO -- In
what health officials believe is the
first time a disease cluster has been
traced to cyberspace, the department of public health here has
tracked an outbreak of syphilis cases
to an America Online chat room.
Officials from the San Francisco
Department of Public Health said six
men who had contracted syphilis in
the last three months have traced
their last sexual encounters to partners they met through a chat room
created by an America Online member, San Francisco Men 4 Men
(SFM4M).
The case is a new development for public health officials
who traditionally define an affected
group by the members' physical
proximity or relation and poses a
question for the electronic age: when
does the right to online privacy yield
to public health issues?
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Trying to trace sex
partners known only
by their computer
nicknames.
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Some of the men who were infected with syphilis know their multiple
partners only by their computer
nicknames, or "handles." While such
anonymity could be an obstacle to
public health officials in other cases,
say among people who met in a bar,
in this case, America Online knows
the participants' real names but
would not divulge them.
So the only
way to contact the scores of sex
partners the syphilis-infected men
met online has been through e-mail
and postings in the chat room itself.
Although the number of men
known to be infected so far is small
and their infections were identified
early and are fully treatable, they
represent a sizable number of the 17
syphilis cases reported in San Francisco this year, and the cluster has
provided a frightening glimpse of a
potentially larger public health risk,
as more and more people use computers to find sex partners, officials
said.
Besides the six men who met partners through the America Online
chat room, which is open only to its
subscribers, a seventh local man
who contracted syphilis since June
said he met his sex partners through
an Internet relay chat room, known
as an I.R.C. Together, the seven men
have identified 99 sex partners in the
last three months -- one man had 47
partners -- and five of the seven men
have H.I.V., the virus that causes
AIDS, health officials said.
At a time when both syphilis and
AIDS cases are at an all-time low in
San Francisco, as in the rest of the
country, officials are now worried
that these seven syphilis cases may
indicate a new venue has been created for unsafe sex. The core group of
individuals using cyberspace to meet
multiple, anonymous sex partners is
the same as that which would use
bathhouses or highway rest stops or
other pick-up venues to engage in
unsafe, potentially dangerous sex,
said Dr. Jeffrey Klausner, the director of the sexually transmitted disease unit at the public health department.
Not only did five of the infected
men expose numerous partners to
H.I.V., but because syphilis causes
open sores that increase the vulnerability to H.I.V., their partners are at
greater risk of contracting the virus,
Dr. Klausner said.
"We've discovered that the Internet chat room is becoming an important sexual network," he said, "and
one that poses particular challenges
for us."
Once the health department traced
the cluster of syphilis cases to the
chat room, Dr. Klausner said he called America Online to find out how the department could contact all the exposed sex partners, as well as those men who might have contact with the exposed men.
America Online does not give out
the names of subscribers as a matter
of policy, unless presented with a
court order or in the event of special
cases like a physical threat, said
Rich Damato, a spokesman. Asked
whether the syphilis cluster constituted a physical threat, he said, "I
would not want in this case to speculate what would constitute a physical
threat."
Dr. Klausner said that the health
department considered trying to subpoena the names of the chat room
subscribers, but "there wasn't a
large enough public health risk to
warrant that."
Instead, in a move applauded by
Internet privacy advocates, America
Online put the health department in
touch with Planet Out, a worldwide
online service in San Francisco for
homosexuals.
Tom Rielly, chairman
of Planet Out said that the service
used e-mails, volunteers and its own
Web site (
www.planetout.com) to get
the word out in the last two weeks to
the chat room users who would be
more likely to read mail from the
service than from other sources.
"What we did first was send a
letter out to the chat room names the
health department obtained from the
men who were infected," Rielly
said. Then, he said, Planet Out posted
instant messages to people who were
in the chat rooms. It also trained 60
volunteers to visit the chat rooms
and talk to people there, and posted
information on its Web site.
Of the 99 men who were directly
exposed to syphilis, 33 have been
tested. Dr. Klausner estimated that
perhaps another third had contacted
their own doctors, while the remaining still do not know that they were
exposed.
Deirdre Mulligan, staff counsel for
the Center for Democracy and Technology, a policy organization in
Washington that advocates protecting privacy rights in the cyber age,
commended the health department
and Planet Out for how they handled
the situation. By contacting people
online, the agency has a chance to
reach not just infected participants,
but also those who may be at risk,
she said. "They're saying, 'Look, be
careful,' " Ms. Mulligan said.
"They're potentially reaching a
much broader audience."
Tim Westmoreland, a senior policy
fellow and public health expert at
Georgetown University Law School,
also applauded the effort. "I've never heard of a case like this -- ever,"
he said. One sticking point, he said, is
that the health department cannot be
certain that infected participants
will return to the chat rooms. But on
the whole, he said, warning people in
chat rooms is an easier way of contacting people and more efficient
than traditional door-to-door methods. "This is a new way of defining
the community," he said. "It's not
defined by physical geography, but
by the use of cyberspace."
(A spokeswoman for the Centers
for Disease Control and Prevention
in Atlanta said that she had never
heard of another cluster traced to
cyberspace, but could not be certain
that one exists but was not reported.)
There are thousands of chat rooms
based in San Francisco alone, encompassing a broad range of subjects and sexual interests.
Rielly
said about 100 to 1,000 of the chat
rooms are geared to gay men and
lesbians. Only perhaps six or seven
of those chat rooms are expressly for
people who want to meet sex partners, he added.
Dr. Klausner of the health department said that since Planet Out began its outreach, the numbers of men
seeking testing at the department's
sex clinics has nearly doubled. But in
a SFM4M chat this afternoon, several participants rejected the notion
that the syphilis cluster is anything
to worry about. One man, who identified himself as a doctor, said incorrectly that the cluster represented a
total of seven cases in San Francisco
in seven months, rather than just
over two months. Another said that
"sex is dangerous no matter how you
cut it."
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