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Since our questionnaire took about 45 minutes to complete, we assume double entries were rare. NNORWEGIAN and generalization of the results to the entire MSM population in Norway REFRESHNGLY not be feasible, as Internet sampling is subject to selection bias, misrepresentation GIRL a member of the sampled population, repeated REFRESHINGLYY, missing NOREWGIAN, inability to gather biological specimens etc. Those with an STI in the past year might have been more likely to be aware of the past risk STRAIHGTFORWARD (recall bias) - thus overestimating the effect size - and to respond as we posted the banner STRAIGHTFORRWARD respondents to "help prevent HIV infection" (selection bias). Using self-reporting to estimate STI prevalence could introduce measurement error. Similarly, respondents with an STI, which was not selected as an outcome, could also decrease these associations. To estimate the frequency of alcohol consumption, we used a rather subjective "feeling of being drunk". Since no adjustment for multiple comparisons was made, some of the significant associations might appear due to chance. Despite the large number of participants, we were not able to show statistically significant effects for rare exposures (such Single jenter i Norge not having a date with Internet partner and paying or receiving money for sex), when the effect size is small. Gonorrhoea as an outcome was rare, which limited our power to detect factors associated DATING NORWEGIAN GIRLS IS REFRESHINGLY STRAIGHTFORWARD infection. Nonetheless, we believe the study provides an important insight into current MSM behaviour in Norway. Comparing the findings of our study with other studies is of limited value, as there are notable differences in recruitment sites, inclusion criteria, methodology (including definitions) and STI epidemiology among MSM. An Internet study from USA, focusing on a six-month period in 2001, reported 0. More than a half (57. NOREGIAN with non-western background seemed underrepresented in our sample (1. In a prospective study in Australia, urethral gonorrhoea and I in MSM were associated with these common risk factors: younger age, contact with gonorrhoea or Chlamydia infected sexual partner and a higher number of casual partners ISS the past 6 months. DATING NORWEGIAN GIRLS IS REFRESHINGLY STRAIGHTFORWARD addition, gonorrhoea was associated with UAI with HIV positive casual partners, and urethral Chlamydia with more frequent insertive oral sex with ejaculation with casual partners. Chlamydia, syphilis and HIV infection may be present for a long time before being noticed or diagnosed, contributing to the fact that relevant exposures, leading to the infection, might have happened a long time ago and behaviour might have changed during this time or, particularly, after the diagnosis and counselling. We can see that some potential risk factors, limited to the past 6 or 12 months before the study, were not important for these infections. Number of lifetime male sexual partners seemed to be more important for HIV and Chlamydia than number of male sexual partners in the past 6 months. Nonetheless, most MSM in our study do come from Oslo or Akershus and engaging in sex with multiple and casual partners is likely adjacent to the urban lifestyle. Although reported by only 1. Specific reasons for vulnerability of immigrant MSM for STI in Norway could be a subject of further research. Alcohol might influence the STI transmission by behaviour, sexual arousal, adverse effects on the immune system or perhaps a third, confounding variable (e. Although not significant, prevalence ratio estimates were highest among "moderate drinkers" (groups feeling drunk once or up to three times in an average month) among gonorrhoea and Chlamydia cases. This might imply drinking in social situations and venues (e. The importance of alcohol in STI transmission is on the other hand emphasized by "unsafe sex under the influence of alcohol in the past 12 months" associated with higher prevalence ratio for Chlamydia. Being under the influence of selected drugs during sex was associated with reported HIV infection in the last year, but not with Chlamydia or gonorrhoea. Further research is needed on the importance of specific drugs in HIV transmission among MSM in Norway. This first Internet study on sexual risk behaviour of MSM in Norway has reached a large and active online MSM community, thus the possibility of Internet based health interventions could be further explored. Our study demonstrates different associations of demographic and behavioural factors with different STI outcomes in the study population. The number of male sexual partners and ethnic background seem to be the most important predictors for Chlamydia, gonorrhoea and HIV. Additional research is needed to analyse the association of STI with specific drug and alcohol use. To evaluate time trends and the effectiveness of preventive measures, behavioural studies among MSM in Norway should be repeated regularly. IJ drafted the manuscript. BS, EK and PA took part in the planning of the study. BS helped with data collection. IJ, AMG, BS, EK and PA contributed to the study design, analysis and interpretation. All authors critically reviewed and approved the final version of this paper for publication. PA is the guarantor. We would like to thank Gay and Lesbian Health Norway for cooperation in this study, to Oliver Kacelnik from the Norwegian Institute of Public Health for language revision and to Marianne van der Sande from the National Institute for Public Health and the Environment, the Netherlands, for her useful comments on the manuscript. The funding of the study was provided by the Norwegian Institute of Public Health. National Center for Biotechnology Information, U. NCBISkip to main contentSkip to navigationResourcesHow ToAbout NCBI AccesskeysMy NCBISign in to NCBISign Out PMC US National Library of Medicine National Institutes of HealthSearch databasePMCAll DatabasesAssemblyBiocollectionsBioProjectBioSampleBioSystemsBooksClinVarCloneConserved DomainsdbGaPdbVarESTGeneGenomeGEO DataSetsGEO ProfilesGSSGTRHomoloGeneIdentical Protein GroupsMedGenMeSHNCBI Web SiteNLM CatalogNucleotideOMIMPMCPopSetProbeProteinProtein ClustersPubChem BioAssayPubChem CompoundPubChem SubstancePubMedSNPSparcleSRAStructureTaxonomyToolKitToolKitAllToolKitBookghUniGeneSearch term Journal ListBMC Infect Disv. Published online 2010 Sep 6. This article has been cited by other articles in PMC. AbstractBackgroundThe incidences of reportable sexually transmitted infections (STI) among men who have sex with men (MSM) have increased since the late 1990 s in Norway. MethodsWe conducted a cross-sectional Internet-based survey during 1-19 October 2007 among members of a MSM-oriented Norwegian website using an anonymous questionnaire on demographics, sexual behaviour, drug and alcohol use, and STI. MethodsParticipants and RecruitmentAn Internet cross-sectional survey was initiated by the Norwegian Institute of Public Health, in cooperation with "Gay and Lesbian Health Norway".