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Use of the internet as a resource for consumer health information: results of the second osteopathic survey of health care in America (OSTEOSURV-II).

BACKGROUND: The Internet offers consumers unparalleled opportunities to acquire health information. The emergence of the Internet, rather than more-traditional sources, for obtaining health information is worthy of ongoing surveillance, including identification of the factors associated with using the Internet for this purpose. OBJECTIVES: To measure the prevalence of Internet use as a mechanism for obtaining health information in the United States; to compare such Internet use with newspapers or magazines, radio, and television; and to identify sociodemographic factors associated with using the Internet for acquiring health information. METHODS: Data were acquired from the Second Osteopathic Survey of Health Care in America (OSTEOSURV-II), a national telephone survey using random-digit dialing within the United States during 2000. The target population consisted of adult, noninstitutionalized, household members. As part of the survey, data were collected on: facility with the Internet, sources of health information, and sociodemographic characteristics. Multivariate analysis was used to identify factors associated with acquiring health information on the Internet. RESULTS: A total of 499 (64% response rate) respondents participated in the survey. With the exception of an overrepresentation of women (66%), respondents were generally similar to national referents. Fifty percent of respondents either strongly agreed or agreed that they felt comfortable using the Internet as a health information resource. The prevalence rates of using the health information sources were: newspapers or magazines, 69%; radio, 30%; television, 56%; and the Internet, 32%. After adjusting for potential confounders, older respondents were more likely than younger respondents to use newspapers or magazines and television to acquire health information, but less likely to use the Internet. Higher education was associated with greater use of newspapers or magazines and the Internet as health information sources. Internet use was lower in rural than urban or suburban areas. CONCLUSIONS: The Internet has already surpassed radio as a source of health information but still lags substantially behind print media and television. Significant barriers to acquiring health information on the Internet remain among persons 60 years of age or older, those with 12 or fewer years of education, and those residing in rural areas. Stronger efforts are needed to ensure access to and facility with the Internet among all segments of the population. This includes user-friendly access for older persons with visual or other functional impairments, providing low-literacy Web sites, and expanding Internet infrastructure to reach all areas of the United States.

Adult↗

The Internet as a newly emerging risk environment for sexually transmitted diseases.

CONTEXT: Transmission of sexually transmitted diseases (STDs) such as human immunodeficiency virus (HIV) infection is associated with unprotected sex among multiple anonymous sex partners. The role of the Internet in risk of STDs is not known. OBJECTIVE: To compare risk of STD transmission for persons who seek sex partners on the Internet with risk for persons not seeking sex partners on the Internet. DESIGN: Cross-sectional survey conducted September 1999 through April 2000. SETTING AND PARTICIPANTS: A total of 856 clients of the Denver Public Health HIV Counseling and Testing Site in Colorado. MAIN OUTCOME MEASURES: Self-report of logging on to the Internet with the intention of finding sex partners; having sex with partners who were originally contacted via the Internet; number of such partners and use of condoms with them; and time since last sexual contact with Internet partners, linked to HIV risk assessment and test records. RESULTS: Of the 856 clients, most were white (77. 8%), men (69.2%), heterosexual (65.3%), and aged 20 to 50 years (84. 1%). Of those, 135 (15.8%) had sought sex partners on the Internet, and 88 (65.2%) of these reported having sex with a partner initially met via the Internet. Of those with Internet partners, 34 (38.7%) had 4 or more such partners, with 62 (71.2%) of contacts occurring within 6 months prior to the client's HIV test. Internet sex seekers were more likely to be men (P<.001) and homosexual (P<.001) than those not seeking sex via the Internet. Internet sex seekers reported more previous STDs (P =.02); more partners (P<.001); more anal sex (P<.001); and more sexual exposure to men (P<.001), men who have sex with men (P<.001), and partners known to be HIV positive (P<.001) than those not seeking sex via the Internet. CONCLUSIONS: Seeking sex partners via the Internet was a relatively common practice in this sample of persons seeking HIV testing and counseling (representative of neither Denver nor the overall US population). Clients who seek sex using the Internet appear to be at greater risk for STDs than clients who do not seek sex on the Internet. JAMA. 2000;284:443-446

Adolescent↗

Survey of doctors' experience of patients using the Internet.

BACKGROUND: There have been many studies showing the variable quality of Internet health information and it has often been assumed that patients will blindly follow this and frequently come to harm. There have also been reports of problems for doctors and health services following patient Internet use, but their frequency has not been quantified. However, there have been no large, rigorous surveys of the perceptions of Internet-aware doctors about the actual benefits and harms to their patients of using the Internet. OBJECTIVE: To describe Internet-literate doctors' experiences of their patients' use of the Internet and resulting benefits and problems. METHODS: Online survey to a group of 800 Web-using doctors (members of a UK medical Internet service provider, Medix) in September and October 2001. RESULTS: Responses were received from 748 (94%) doctors, including 375 general practitioners (50%). Respondents estimated that 1%-2% of their patients used the Internet for health information in the past month with no regional variation. Over two thirds of the doctors considered Internet health information to be usually (20%) or sometimes (48%) reliable; this was higher in those recently qualified. Twice as many reported patients experiencing benefits (85%; 95% confidence interval, 80%-90%) than problems (44%; 95% confidence interval, 37%-50%) from the Internet. Patients gaining actual physical benefits from Internet use were reported by 40% of respondents, while 8% reported physical harm. Patients' overall experiences with the Internet were judged excellent 1%, good 29%, neutral 62%, poor 9%, or bad <1%. Turning to the impact of patient Internet use on the doctors themselves, 13% reported no problems, 38% 1 problem, and 49% 2 or more problems. Conversely, 20% reported no benefits for themselves, 49% 1 benefit, and 21% 2 or more benefits. CONCLUSIONS: These doctors reported patient benefits from Internet use much more often than harms, but there were more problems than benefits for the doctors themselves. Reported estimates of patient Internet usage rates were low. Overall, this survey suggests that patients are deriving considerable benefits from using the Internet and that some of the claimed risks seem to have been exaggerated.

Attitude to Computers↗

Internet usage among women with breast cancer: an exploratory study.

An increasing number of breast cancer patients are accessing the Internet for medical information. A survey was administered to breast cancer patients and their families attending follow-up outpatient clinics in a comprehensive cancer care center to explore their frequency of Internet use, their motivation for online activity, the type of information they sought, and the perceived impact of the information they found on the Internet on their medical care. The survey was conducted over a 4-month period. A total of 107 surveys were returned. Seventy-nine of these (74%) were from patients while 28 (26%) were from family members and friends. Thirty-four of the patient responses (43%) indicated that the patient had used the Internet to look for cancer-related information. Patients who had used the Internet to access cancer-related information were significantly younger (P = 0.007), better educated (P = 0.027), and less satisfied with the amount of treatment-related information given by caregivers than those patients who had not used the Internet to access cancer-related information (P = 0.032). The majority of patient Internet users desired more information on their cancer and its treatment (91%), looked up information that was presented to them by their clinicians (66%), researched other treatment options (63%), and obtained more information on "alternative treatments" (63%). Patient Internet users generally found the cancer-related information on the Internet to be useful, and the majority discussed Internet-derived information with their health care providers and perceived that clinicians listened to such information. However, 53% were undecided about the trustworthiness of the medical information obtained via the Internet. Internet nonusers commonly lacked Internet access (53%) or were unfamiliar with the Internet (33%), but few (13%) distrusted Internet-derived information. This exploratory study underscores the need for more research in this area, specifically with the aims of identifying and verifying factors that lead patients to use the Internet and the impact of their online activities on their medical care.

Adult↗

Is the Internet useful for clinical practice?

BACKGROUND: Internet use in dentistry is increasing. The authors surveyed dentists to determine how they are using the Internet to support patient care and how useful they perceive the Internet to be. MATERIALS AND METHODS: The authors sent a 25-question survey to 455 subscribers to the Internet Dental Forum, an Internet discussion list. Participants completed the survey through a Web page or by e-mail during an 18-day period in December 1998. The survey included questions about when they began using the Internet and their motivations for doing so, their positive and negative experiences, where they use the Internet and why, their use of information resources--including electronic information resources--and demographics. RESULTS: The authors received 314 surveys from 438 participants, a 72 percent response rate. Participants reported demographic characteristics similar to national averages and were highly computer-literate. Most considered the Internet essential for their practice and had increased their Internet use for professional reasons over time. Ninety-seven percent of respondents used the Internet at home, and 68 percent used it in the office. Only 5 percent used the Internet in the treatment area. The primary reason cited by participants for using the Internet was to keep up in general, followed by to answer patient-specific questions and to provide patient education. Reduction of professional isolation was one of the most frequently cited advantages of using the Internet. CONCLUSIONS: The authors found that some dentists use the Internet to support clinical practice and that it helped dentists adopt new techniques for patient treatment and obtain information on new materials or products. CLINICAL IMPLICATIONS: The Internet appears to support clinical practice mostly indirectly, by helping users keep up in general, rather than by answering specific clinical questions.

Adult↗

Internet use in families with children requiring cardiac surgery for congenital heart disease.

OBJECTIVE: We sought to document the prevalence of Internet access and usage patterns among families who have children with congenital heart disease presenting for cardiac surgery. DESIGN: A cross-sectional study was performed utilizing a questionnaire (10 questions) as the study tool. Statistical analysis was performed on all completed questionnaires. The chi(2) test was used to evaluate categorical variables and the t test to evaluate continuous variables. RESULTS: Two hundred seventy-five questionnaires were completed and analyzed. Thirty-seven percent (102/275) of the children had a cyanotic congenital heart defect. There were 21 children with Trisomy 21. Fifty-eight percent (160/275) of families had access to the Internet. The most common locations for accessing the Internet were home (80%; 129/160) and work (51%; 82/160). There were no significant differences in Internet access with regards to underlying individual congenital heart defect, cyanotic versus acyanotic heart defects, or congenital heart defects with functional univentricular hearts versus biventricular hearts. Families with older children (12--24 years) were more likely to have Internet access. Families of children undergoing placement of a right ventricle to pulmonary artery conduit were more likely to have Internet access. Of the 160 families with Internet access, 58% (93/160) used the Internet to obtain information related to their child's cardiac diagnosis. Eighty-two percent (76/93) characterized locating cardiology-related information as easy. Six parents created interactive personal Web sites specifically related to their child's congenital heart defect. Although families with older patients (12--24 years) were more likely to have access to the Internet, this did not translate into greater use of the Internet to obtain cardiology-related information. Among families who accessed the Internet for cardiology-related information, 95% (88/93) of families characterized the information as helpful or very helpful in furthering the understanding of their child's heart defect. CONCLUSION: Families are utilizing the Internet to educate themselves about congenital heart disease. Most parents consider the process easy and the information obtained helpful to the understanding of their child's congenital heart defect and surgery. Internet use in this patient population is expected to increase. Our vigilance in providing accurate Internet references, as well as in identifying inaccurate Internet information available to our patients and their parents, is of paramount importance.

Adolescent↗

Swiss community pharmacies' on the Web and pharmacists' experiences with E-commerce: longitudinal study and Internet-based questionnaire survey.

BACKGROUND: There are multiple ways in which community pharmacies can present themselves on the Internet, e.g., as a platform for drug information or as an advertising platform for their services. OBJECTIVE: To estimate the number of Swiss community pharmacies on the Internet over the period of 32 months (2000-2003), to describe their current e-commerce services, and to explore the experiences and plans these pharmacies have with regard to their Internet presence. METHODS: A longitudinal study was performed to determine the number of Swiss German pharmacies on the Internet by conducting Internet searches in 2000, 2001, and 2003. In April 2002, a cross-sectional Internet-based survey was administered to explore the pharmacies' experiences and plans regarding their Web sites. RESULTS: As of April 2003, 373 (44%) of 852 community pharmacies from the German speaking part of Switzerland were on the Internet. One hundred eighty four listed an e-mail address and were asked to complete a questionnaire. Of the 107 pharmacies answering the survey questions (58% response rate): 46% had been on the Internet for 1 to 2 years; 33% of the Web sites are part of a pharmacy group's Web portal; 31% of the pharmacies plan to expand their Internet appearance in the future; 74% provide e-commerce services, with 81% of those pharmacies filling five or less orders per month; and 12% plan on expanding their e-commerce services in the future. CONCLUSIONS: The number of community pharmacies offering Internet services steadily increased over 32 months. Given the importance of the Internet as a tool for information, communication, and advertising for pharmacy products and services, it can be expected that the increase will continue. Pharmacy-group portals are important promoters of pharmacies on the Internet. For many community pharmacies, Internet portals that provide an Internet presence for the pharmacies and provide regularly-updated content (e.g., health news, tips, drug information) seem to be the most effective solutions. Even though 40% of the pharmacies already offer e-commerce services, these services are still of minor importance. For many pharmacists, the current legal regulations seem to be unclear. Most pharmacies want to maintain their Internet services.

Commerce↗

Urban girls, internet use, and accessing health information

Background: With the burgeoning growth of the Internet, many have raised concerns over whether and how underserved populations might be included in the Information Revolution. This study examines how urban adolescent girls access the Internet and whether it is a viable source for health information.Methods: During Fall 1999 in New York City, 176 girls completed an anonymous survey where half were from a private high school (N = 86) and the other half were patients at a health clinic serving ethnically diverse and disadvantaged youth (N = 90). Data were analyzed to provide information on how urban girls use the Internet.Results: Internet use was widespread; 99% of the high school and 83% of the clinic girls said they used this medium (p <.001). On frequency, 32% of high school girls compared to 13% of the clinic girls used the Internet 6-7 days/wk (p <.001). Among the high school girls, 30% indicated that they used the Internet less than 30 min/wk and another 18% reported using the Internet more than 5 hrs/wk. Among clinic girls, 51% used the Internet less than 30 min/wk while 9% reported more than 5 hrs/wk. Comfort levels differed with 20% of the high school compared to 10% of the clinic girls reporting "extreme" comfort using the Internet (p <.001).Urban girls accessed the Web from multiple locales. Almost all (98%) of the high school girls compared to 45% of the clinic girls reported that they used the Internet from home (p <.001). Most high school girls (82%) used the Internet at school compared to 63% of the clinic girls currently in school (p <.05). More clinic girls used the Internet at another family member's house (28% vs. 14%, p <.05). Similar percentages of high school and clinic girls used the Internet at a friend's house (46%), the library (31%), or a community center (3%).With similar rates among high school and clinic girls, 44% reported that they had tried to get health information from the Web. Of these (N = 74), 50% said that they got information on different diseases, 43% on diet/nutrition, 34% on fitness/exercise, 26% on sex, 24% on alcohol/drug abuse, 20% on mental health, 14% on medicines, 12% on violence among peers, 10% on parenting, 8% on violence among dating partners, 7% on tobacco and smoking, 7% on emotional or physical abuse, 3% on sexual abuse, and 1% on illness support groups. Clinic girls were more likely to have tried to get information on sex (p <. 001) and parenting (p <.001) from the Web. Many girls (59%) indicated that it was "very" or "extremely" worthwhile to have general health information on the Web, with no significant differences between high school and clinic girls. As well, 71% and 62% said it was "very" or "extremely" worthwhile to have access to contraceptive and diet/nutrition information, respectively. Conclusions. High school girls, as anticipated, were technologically savvy. Somewhat surprising, however, were the clinic girls' high levels of Internet use and access. Significant differences revealed that the high school girls were more on-line than clinic girls, but clinic girls were still using the Web frequently. A considerable number or urban girls had tried to get a range of health information from the Internet. This study offers promising statistics on how urban adolescent girls are accessing and using the Internet, especially for health information.

Journal Article↗

Internet use and stigmatized illness.

People with stigmatized illnesses often avoid seeking health care and education. The internet may be a useful health education and outreach tool for this group. This study examined patterns of internet use for health information among those with and without stigmatized illnesses. A national survey of internet users in the USA was conducted. Respondents who self-reported a stigmatized condition-defined as anxiety, depression, herpes, or urinary incontinence-were compared to respondents who reported having at least one other chronic illness, such as cancer, heart problems, diabetes, and back pain. The analytical sample consisted of 7014 respondents. Cross-sectional associations between stigmatized illness and frequency of internet use for information about health care, use of the internet for communication about health, changes in health care utilization after internet use, and satisfaction with the internet were determined. After controlling for a number of potential confounders, those with stigmatized illnesses were significantly more likely to have used the internet for health information, to have communicated with clinicians about their condition using the internet, and to have increased utilization of health care based on information found on the internet, than those with non-stigmatized conditions. Length of time spent online, frequency of internet use, satisfaction with health information found on the internet, and discussion of internet findings with health care providers did not significantly differ between the two groups. Results from this survey suggest that the internet may be a valuable health communication and education tool for populations who are affected by stigmatized illnesses.

Adolescent↗

What influences children's and adolescents' understanding of the complexity of the Internet?

This study aimed at analyzing complex relationships among Internet use, Internet users, and conceptual understanding of the Internet. It used path models to examine factors related to Internet use (duration of Internet use, frequency of Internet use, and informal Internet classes) and Internet users (age and gender) in affecting understanding of the technical and social complexity of the Internet for 322 elementary and middle school students. The findings of the study indicate that (a) age of young Internet users had predominant effects on both the technical and social understanding of the Internet; (b) frequency of Internet use and informal Internet classes had small but significant effects on social understanding, but no effect on technical understanding; and (c) technical understanding had a unidirectional effect on social understanding. The implications of these findings for the implementation of the Children's Internet Protection Act are discussed.

Adolescent↗

The Internet and HIV study: design and methods.

BACKGROUND: The Internet provides a new meeting ground, especially for gay men, that did not exist in the early 1990s. Several studies have found increased levels of high risk sexual behaviour and sexually transmissible infections (STI) among gay men who seek sex on the Internet, although the underlying processes are not fully understood. Research funded by the UK Medical Research Council (2002-2004) provided the opportunity to consider whether the Internet represents a new sexual risk environment for gay and bisexual men living in London. METHODS: The objectives of the Internet and HIV study are to: (i) measure the extent to which gay men living in London seek sexual partners on the Internet; (ii) compare the characteristics of London gay men who do and do not seek sex on the Internet; (iii) examine whether sex with Internet-partners is less safe than with other sexual partners; (iv) compare use of the Internet with other venues where men meet sexual partners; (v) establish whether gay men use the Internet to actively seek partners for unprotected anal intercourse; (vi) determine the potential for using the Internet for HIV prevention. These objectives have been explored using quantitative and qualitative research methods in four samples of London gay men recruited and interviewed both online and offline. The four samples were: (i) gay men recruited through Internet chat rooms and profiles; (ii) HIV positive gay men attending an NHS hospital outpatients clinic; (iii) gay men seeking an HIV test in an NHS HIV testing or sexual health clinic; (iv) gay men recruited in the community. RESULTS: Quantitative data were collected by means of confidential, anonymous self-administered questionnaires (n>4000) completed on-line by the Internet sample. Qualitative data were collected by means of one-to-one interviews (n = 128) conducted either face-to-face or on-line. CONCLUSION: The strength of the Internet and HIV study is its methodological plurality, drawing on both qualitative and quantitative research among online and offline samples, as well as taking advantage of recent advances in web survey design. The study's findings will help us better understand the role of the Internet in relation to gay men's sexual practice.

Adult↗

Internet use among Ugandan adolescents: implications for HIV intervention.

BACKGROUND: The Internet is fast gaining recognition as a powerful, low-cost method to deliver health intervention and prevention programs to large numbers of young people across diverse geographic regions. The feasibility and accessibility of Internet-based health interventions in resource-limited settings, where cost-effective interventions are most needed, is unknown. To determine the utility of developing technology-based interventions in resource-limited settings, availability and patterns of usage of the Internet first need to be assessed. METHODS AND FINDINGS: The Uganda Media and You Survey was a cross-sectional survey of Internet use among adolescents (ages 12-18 years) in Mbarara, Uganda, a municipality mainly serving a rural population in sub-Saharan Africa. Participants were randomly selected among eligible students attending one of five participating secondary day and boarding schools in Mbarara, Uganda. Of a total of 538 students selected, 93% (500) participated. Of the total respondents, 45% (223) reported ever having used the Internet, 78% (175) of whom reported going online in the previous week. As maternal education increased, so too did the odds of adolescent Internet use. Almost two in five respondents (38% [189]) reported already having used a computer or the Internet to search for health information. Over one-third (35% [173]) had used the computer or Internet to find information about HIV/AIDS, and 20% (102) had looked for sexual health information. Among Internet users, searching for HIV/AIDS information on a computer or online was significantly related to using the Internet weekly, emailing, visiting chat rooms, and playing online games. In contrast, going online at school was inversely related to looking for HIV/AIDS information via technology. If Internet access were free, 66% (330) reported that they would search for information about HIV/AIDS prevention online. CONCLUSIONS: Both the desire to use, and the actual use of, the Internet to seek sexual health and HIV/AIDS information is high among secondary school students in Mbarara. The Internet may be a promising strategy to deliver low-cost HIV/AIDS risk reduction interventions in resource-limited settings with expanding Internet access.

Adolescent↗

Internet use by parents of children undergoing outpatient otolaryngology procedures.

OBJECTIVES: (1) To determine the prevalence of Internet medical information searches by parents prior to their child's surgical procedure, and (2) to evaluate whether Internet-based health information influences parents' medical decisions on behalf of their children. DESIGN: A questionnaire designed to gather information regarding preoperative use of the Internet by parents of children who were scheduled to undergo outpatient otolaryngology procedures. Parents were asked to respond to questions regarding Internet searches for information specific to their child's diagnosis and anticipated surgical procedure. SETTING: Tertiary care pediatric hospital. RESULTS: Internet access was available to 83% of respondents. Of those parents with Internet access, 48% searched the Internet for information regarding their child's diagnosis and surgical procedure. Of those who searched the Internet, 93% said they found information that was both understandable and helpful. More important, 84% of parents using the Internet said the information influenced or somewhat influenced the medical decisions they made on behalf of their child. Only 43% of parents discussed the information they found on the Internet with their child's surgeon. CONCLUSIONS: Approximately 50% of the parents in our study with Internet access used it to find medical information prior to their child's surgery. Parents who used the Internet found the information helpful and influential, although physicians remain the most important source of information that guides a parent or patient in their medical decision making. Ideally, surgeons would direct parents or patients to a few trusted Internet sites and be prepared to discuss this information.

Adolescent↗

Medical genetics and patient use of the Internet.

Clinical experience suggests that the Internet is increasingly becoming a resource for patients seen in medical genetics. A prospective analysis was performed exploring patient use of the Internet prior to attending a medical genetics appointment. We administered 200 questionnaires assessing: 1) the frequency of patient use of the Internet for genetic information, 2) factors associated with Internet use, 3) patient assessment of the value of the information, and 4) patient views of the responsibility of medical genetics professionals to be familiar with Internet information. Results show that 77% (153/200) of patients have access to the Internet of which 29% (44/153) report searching the Internet for genetic information. A correlation was found between patient use of the Internet and reason for referral (p<0.001), presence of a specific diagnosis (p<0.001), and frequency of Internet use (p<0.05). Overall, 80% (33/41) of patients found Internet information useful. Seventy-four percent (115/155) believed that medical genetics professionals have a responsibility to review relevant Internet sites for accuracy and 80% (123/153) felt that professionals should provide their patients with appropriate and useful Internet sites. These results suggest that the role of medical genetics professionals is changing as a result of the development of the Internet.

Female↗

The use of the Internet within a dental school.

The Internet is an increasingly popular medium for delivering educational material. The aim of this study was to determine the attitudes of students and their clinical teachers to the use of the Internet within a dental school in the UK. Questionnaires were distributed to undergraduate dental students in the three clinical years and to all their clinical academic teachers. All students and staff have access to computers and Internet at the university. The majority (72%) of students have access to a computer and 53% also have access to the Internet at home. Of the academic staff, 91% have a computer and 68% have access to the Internet at home. The reasons for use of the Internet differed between staff and students. Whilst equal proportions of students used the Internet for dentistry (38%) and for pleasure (35%), a higher proportion of staff used the Internet more for dentistry (36%) than for pleasure (14%). Students highlighted cost and time as barriers to Internet use, whereas staff lacked confidence in their ability to use the Internet. Less than half (44%) of the students are confident in the accuracy of information from the Internet compared to almost two-thirds (64%) of staff. This study revealed differences in the attitudes of staff and students to the use of Internet as a resource for dentistry. Students are positive to the suggestion that lectures should be presented on the web. Most students (74%) did not see that this would influence attendance at lectures whilst 91% of staff stated that it would decrease lecture attendance. In conclusion, this study revealed differences in the attitudes of staff and students to the use of Internet as a resource for dentistry.

Attitude of Health Personnel↗

Internet use among people living with HIV/AIDS: coping and health-related correlates.

People living with HIV/AIDS may experience health benefits from using the Internet for accessing health information as well as potential health hazards, including seeking sex partners online. This study examined how people with HIV/AIDS are using the Internet and how their Internet use may be associated with health behaviors. HIV-positive men (n = 347) and HIV-positive women (n = 72) who reported using the Internet were recruited from community services to complete an anonymous survey of their Internet use and associated factors. HIV-positive Internet users reported using the Internet for a wide range of purposes, with health related searches for information accounting for 1 of 3 Internet activities. People with greater income and more education were more likely to use the Internet for health functions. Health-related Internet use was related to a broader spectrum of health behaviors including HIV treatment adherence and health-related Internet use was associated with active coping strategies and indicators of better health. HIV-positive men and women are frequently using the Internet to access health-related information as well as for other nonhealth-related functions. Searching the Internet for health information can be conceptualized as an active coping strategy, occurring with other health-related behaviors and offering potential health benefits.

Acquired Immunodeficiency Syndrome↗

Current Internet use and preferences of IVF and ICSI patients.

BACKGROUND: Nowadays, the Internet has a tremendous impact on modern society, including healthcare practice. The study aim was to characterize current Internet use by IVF and ICSI patients and to identify their preferences regarding Internet applications in fertility care. METHODS: A total of 163 couples with fertility problems awaiting an IVF or ICSI procedure in the University Medical Centre Nijmegen, The Netherlands, was asked to complete a written questionnaire on Internet use in general, and also for fertility-related problems, preferences regarding Internet applications in fertility care and demographic characteristics. RESULTS: The response rate was 82%. In total, 81% of infertile couples used the Internet. Multivariate logistic regression analysis showed ethnic background and annual family income to be significant predictors of Internet use. Some 66% of Internet users and 54% of the total study population used the Internet for fertility-related problems. The female partners were the main Internet users with regard to fertility-related issues. In terms of preferences of the study participants, the majority favoured personal medical information online. CONCLUSIONS: Most infertile couples used the Internet with respect to fertility-related problems and were interested in implementation of Internet applications in fertility care. Healthcare providers should actively participate in the development and implementation of Internet applications in fertility care.

Adult↗

Risks and benefits of the internet for populations at risk for sexually transmitted infections (STIs): results of an STI clinic survey.

BACKGROUND: The Internet is increasingly used for the recruitment of sex partners, potentially leading to increased risks for sexually transmitted infections (STIs). Less is known about the use of the Internet as a resource for STI education and prevention. GOAL: To evaluate the use of the Internet for sex-seeking and STI information purposes by clients of a large STI clinic. STUDY DESIGN: A 10-item survey was conducted among clients of the Denver Metro Health (STI) Clinic who visited the clinic for a new problem between September 2000 and May 2001. RESULTS: Among 4,741 clients surveyed, 2,159 (45.5%) had Internet access. Of these, 138 (6.4%) reported to have gone on-line with the specific purpose of finding a sex partner and 146 (6.8%) reported having sex with a partner they found over the Internet. Internet sex-seeking was more common among men who have sex with men (MSM; 77/269, or 28.6%) than among men who have sex with women (MSW; 52/1,176, or 4.4%; P < 0.0001) and higher among MSW than among women (9/714, or 1.3%; P < 0.001). The Internet was accessed by 604 persons (28.0%) to find information on STIs. Of these, 65.1% did so for general STI information, 36.3% for information on HIV, 25.7% for information on genital herpes, 22.4% for information on chlamydia, 21.7% for information on HPV, 19.9% for information on gonorrhea, 16.1% for information on syphilis, and 9.3% for other information. Of persons seeking sex, 54.4% accessed the Internet for STI information, compared to 26.2% of persons not seeking sex (P < 0.0001). CONCLUSIONS: Among STI clinic clients in Denver, nearly half have access to the Internet. Sex-seeking appears to be most prevalent among MSM. Internet use for STI information is common among those with Internet access and even more widespread among those who access the Internet to seek sex. Research is needed to develop and evaluate Internet-based STI-prevention interventions.

Adult↗