Is the Web the culprit? Cognitive escape and Internet sexual risk among gay and bisexual men.

Men who have Sex with Men (MSM) who find partners on the Internet tend to be sexually risky. A "cognitive escape" perspective maintains that feeling overwhelmed by rigorous sexual norms may lead one to cognitively disengage from these demands as a coping strategy. We thus proposed that the Internet might facilitate less restrained behavior among men whose psychological characteristics make them vulnerable to "escape"-based risk. We tested this in a socio-economically and ethnically diverse cross sectional survey sample of MSM, n=817. Men who sought sex on-line reported more unprotected sex and sexually transmitted infections, controlling for demographics and overall number of sex partners. Consistent with an escape perspective, partner choice and sexual context, alcohol and drug use, and "burnout" or fatigue over sexual safety mediated the relationship between Internet use and sexual risk. The Internet is not an isolated source of risk; interventions must address the psychosocial aspects of this venue.