Sexually transmitted infections. Internet. Cognitive escape

Abstract Men who have Sex with Men (MSM) who find partners on the Internet tend to be sexually risky. A “cogni-tive escape ” perspective maintains that feeling overwhelmed by rigorous sexual norms may lead one to cognitively dis-engage from these demands as a coping strategy. We thus proposed that the Internet might facilitate less restrained be-havior 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 num-ber 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 rela-tionship between Internet use and sexual risk. The Internet is not an isolated source of risk; interventions must address the psychosocial aspects of this venue