This study explored how mentoring begins and the benefits provided for African American sexual and/or gender minority (SGM) youth. Participants were mentors and mentees living in three Mid-Atlantic cities. Mentees (ages 15–21, n = 14) identified as African American; cisgender male, transgender female, or non-binary assigned male; and had sexual interest in men. Mentor participants (ages 18+, n = 13) mentored such youth. Qualitative in-depth interviews were conducted with mentoring relationship partners (both partners did not necessarily participate). All interviews were audio-recorded, transcribed, and imported into Atlas.ti. Using a basic interpretive qualitative analysis, a codebook was developed through inductive and deductive techniques. Analysis focused on mentees’ and mentors’ descriptions and interpretations about how they formed a mentoring relationship and any observed benefits that arose. Themes showed mentoring relationships were formed through introductions via social circles or social media. Mentoring was described as providing a trusted confidant and support with identity formation, relationships, transitioning to adulthood, and health. Results indicate a potential for natural mentoring relationships to provide trusted adult support to SGM adolescents in ways that are experienced as authentic and beneficial to the mental health of African American SGM male youth.

Electronic mentoring (e-mentoring), the integration of digital technology in mentoring relationships, has recently grown in popularity; however, the effectiveness of e-mentoring in addressing youth health has not been synthesized to date. The current study synthesizes the literature on e-mentoring to affect the health and well-being of youth (10–24 years) through a systematic review and evidence quality assessment. A total of 833 records were identified, of which 14 met eligibility criteria (published in English since 1995, targeted youth health and/or youth with health issues, and communication was entirely digital or combined with in-person interaction). The results showed that the majority of health-focused e-mentoring studies were conducted with young people with existing health conditions rather than on the use of e-mentoring to promote overall health and wellness. The included programs focused largely on bringing mentoring to youth subpopulations that may be challenged by in-person models. Quality assessments of the included studies showed that the strength of the evidence is mediocre. The findings suggest that e-mentoring has the potential to reach youth with unique health concerns and to promote independent management of health conditions as youth transition to adulthood; however, more rigorous evaluation of e-mentoring programs with larger sample sizes is needed.

COVID-19 is having major repercussions for children and adolescents’ mental health and well-being.Children and youth who are low-income, marginally housed, and in the throes of trauma and/or abuse are particularly vulnerable, as the public safety net upon which they rely was unable to address a documented mental health crisis that existed well before the pandemic. current efforts to provide laptops and internet hotspots for distance learning during COVID-19 offers an opportunity to connect more children to their mental health providers post-pandemic.

Objectives: Transient ischemic attack (TIA) patients are at high risk of recurrent vascular events; timely management can reduce that risk by 70%. The Protocol-guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) trial evaluated the implementation of a quality improvement (QI) program aligned with Learning Healthcare System principles to improve TIA care. Methods: A facility-based, stepped-wedge trial was conducted at six diverse sites. The intervention included five components: clinical programs, data feedback, professional education, electronic health record tools, and QI support. Implementation strategies included: team activation via audit and feedback, goal setting, reflecting and evaluating, and planning; external facilitation; and building a community of practice. The primary effectiveness outcome was the Without Fail rate (WFR); proportion of TIA patients who received all processes of care for which they were eligible among: brain imaging, carotid artery imaging, neurology consultation, hypertension control, anticoagulation for atrial fibrillation, antithrombotics, high/moderate potency statins. The primary implementation outcomes were the number of improvement activities completed and the Group Organization (GO) scores for providing and improving care (scale of 1-10). Results: The 6 PREVENT facilities cared for N=162 control period TIA patients and N=191 intervention period TIA patients. The mean facility WFR increased from 36.7% (baseline) to 53.9% (active implementation); p=0.002 (adjusted for temporal trend, hospital admission). The mean number of improvement activities completed during the 1-year implementation period was 26 (range 11-39). The mean facility GO scores increased: providing care, 1.2 to 6.5; improving care, 1.0 to 6.7. Conclusions: PREVENT advances three aspects of a learning healthcare system: Learning from Data (teams interacted with their facility’s performance data to explore hypotheses, plan QI activities, and evaluate change over time); Learning from Each Other (teams participated in monthly virtual collaborative conferences), and Sharing Best Practices (teams shared tools and protocols).

Background African American men who have sex with men (MSM) and transgender women bear a disproportionate burden of HIV. Young MSM account for 75% of this burden for youth. When youths lack socially protective resources such as strong networks of adults, including parents, teachers, or community members, mentors may play a critical role in promoting health behaviors. This is especially true for youth at risk for HIV, such as African American youth with sexual and gender minority (SGM) identities. In the past decade, natural mentoring and mentoring programs have proliferated as a key prevention and intervention strategy to improve outcomes for young people at risk for poor academic, social, and health issues. Mentors appear to be able to facilitate health promotion among young SGM by modeling healthy behaviors; however, mentors’ knowledge and resource needs regarding sexual health topics including HIV are understudied, as is the potential role of mobile technology in enhancing mentoring relationships and the ability of mentors to learn about sensitive issues faced by youth. Objective The aim of this study is to explore how mentoring plays a role in the sexual health of African American SGM youth and understand how mentoring relationships can be strengthened through mobile technology to promote youth HIV prevention behaviors. Methods In-depth interviews were conducted with African American SGM youth mentees (n=17) and mentors (n=20) to such youths in 3 Mid-Atlantic cities. Mentee interviews focused on discussions regarding sexual health and HIV and how a mentor could broach such topics. Mentor interviews explored whether sexual health and HIV are currently mentoring topics, mentors’ knowledge and confidence in mentoring on these issues, and barriers to discussions. All participants were asked if a mobile app could help facilitate mentoring on sensitive health issues, particularly HIV and sexual health. Data were transcribed, coded, and analyzed for relevant themes. Results Sexual health was a common topic in mentoring relationships, occurring more in natural mentorships than in mentoring program pairs. Mentors and mentees felt positive about such discussions. Mentors expressed having limited knowledge beyond condom use and HIV testing, and expressed a need for more complete resources. Both mentors and mentees had mixed comfort levels when discussing sexual health. Sufficient trust and shared lived experiences made discussions easier. Mentees have multifaceted needs; however, mentors stated that an app resource that provided self-training, resources, support from other mentors, and tips for better mentoring could prove beneficial. Conclusions For the African American SGM community, access to natural mentors is crucial for young people to learn healthy behaviors. A mobile resource to assist mentors in confidently having discussions with mentees may be a promising way to promote healthy practices.

Background Patient-initiated partner notification (PN) is a cornerstone of STD control in resource-limited public health systems. We conducted a randomised, controlled trial of two new tools to support PN among MSM: anonymous, internet-based notification systems and patient-delivered partner referral cards. Methods We screened 1,625 MSM for syphilis in Lima, Peru between 2012–2014. Enrollment was limited to MSM with symptomatic primary or secondary syphilis (n = 133) and/or latent syphilis diagnosed by RPR/TPPA (n = 406; Seroprevalence: 25.0%). After enumerating all recent partners and providing details of their three most recent partners, 370 participants were randomly assigned to four intervention arms: 1) Standard PN Counselling (Control) [n = 94]; 2) Counselling and Referral to Internet PN (www.inspot.org) [n = 95]; 3) Counselling and Provision of 5 Partner Referral Cards [n = 97]; or 4) Counselling with both Internet PN and Partner Referral Cards [n = 84]. Self-reported notification of recent sexual partners was assessed by CASI among the 354 participants who returned for 14-day follow-up. Results The median age of participants enrolled was 27 (IQR: 23–34), with a median of 3 partners (IQR: 1–5) in the past month and a baseline HIV seroprevalence of 64.1%. Participants referred to internet PN (Arms 2 and 4) or provided with printed partner referral cards (Arms 3 and 4) were more likely to have notified ≥1 partners at 14-day follow-up than participants who received only PN counselling (OR: 2.26 [95% CI: 1.33, 3.82] and 1.94 [95% CI: 1.15, 3.27], respectively). The fraction of all recent partners notified was significantly greater in the Internet PN (56.5%, p < 0.001) and Referral Card (50.8%, p = 0.006) arms than the Control arm (35.3%). Conclusions Internet notification systems and printed partner referral cards provide inexpensive, effective tools to support patient-directed PN, significantly improving notification by Peruvian MSM with syphilis. Additional research is needed to optimise use of different PN technologies in specific partnership contexts.

An estimated 2.5 million youth, ages 16-24, experience homelessness in the US each year. These young individuals, particularly women, are considered high-risk for serious health problems, including HIV, STDs, teen pregnancy and teen dating violence. Healthcare providers can play a critical role in providing appropriate care to homeless youth and in linking them to other health services. Research suggests that linking healthcare with other services needed by homeless adolescents, such as shelter or food, may help improve their continuity of care. In this paper, we describe Youth StreetConnect, a tool formed by two mobile apps, which will connect young homeless women to local healthcare providers. Considering that cellular phones are common among homeless individuals, particularly teenagers, our tool has the potential to make an impact on these women's lives.

“The same thing happens repeatedly whenever a new technology is introduced into Western popular culture: It becomes an instrument with which to terrify ourselves and others about sex” [[1]Klein M. America's war on sex: the attack on law, lust and liberty. Praeger, Westport, CT2008Google Scholar].In this quote, Dr. Marty Klein was speaking about the introduction of the Internet in the 90s; the same holds true for the mobile phone today.Mobile phones are ubiquitous in our culture, particularly among teens and young adults. Seventy-seven percent of teens aged 12–17 years own a cell phone, and 85% of people aged >18 years are cell phone owners as well [[2]Teen Gadget OwnershipThe Pew Research Center's Internet and American Life Project, 2011 Teen/Parent Survey.http://pewinternet.org/Static-Pages/Trend-Data-%28Teens%29/Teen-Gadget-Ownership.aspxGoogle Scholar]. With all the incredible uses of the mobile phone that have been implemented and those imagined, but not yet invented, what has the media been reporting on for the past 2 years? Sexting.Sexting describes sharing sexually suggestive photos and messages through cell phones and other mobile media [[3]Chalfen R. It's only a picture: Sexting, smutty snapshots and felony charges.Vis Stud. 2009; 24: 258-268Crossref Scopus (30) Google Scholar]. According to Gordon-Messer et al in this month's issue, sexting has indeed caused substantial fear over its legality and safety, both in the peer-reviewed literature and the mainstream press [4Diliberto GM, Mattey E, Sexting NASN School of Nursing 2009;24:263–7.Google Scholar, 5Katzman D.K. Sexting: Keeping teens safe and responsible in a technologically savvy world.Paediatr Child Health. 2010; 15: 41-42PubMed Google Scholar, 6Hoffman J. A girl's nude photo and altered lives. New York Times, March 26, 2011http://www.nytimes.com/2011/03/27/us/27sexting.html?pagewanted=allGoogle Scholar].Much of the concern has been around teenagers and underage distribution of explicit materials. However, the two articles in this month's edition look at young adults aged 18–24 years, and the connections between sexting and health risk behaviors. Interestingly enough, one found connections between sexting and risky behaviors, and the other found no connections between sexting and sexual risk behaviors and psychological well-being.The greater question we need to ask, however, is why we are even starting from a place that sharing sexy pictures might be linked to unhealthy behaviors in young adults? Young adults are in the prime of their sexual lives. People aged 18–29 years have more sex (112 times per year) than any other age-group [[7]Herbenick D. Schick M. Sanders V. et al.Sexual behavior in the united states: Results from a national probability sample of men and women ages 14–94.J Sex Med. 2010; 7: 255-265Crossref PubMed Scopus (450) Google Scholar], and sharing of sexual pictures of people aged >18 years, between consenting adults, is protected under the first amendment.In one of the two studies, the researchers were able to debunk the fear-based myths that surround sex and technology, and risk-taking behaviors [[8]Gordon-Messer D. Bauermeister J.A. Grodzinski A. Zimmerman M. et al.Sexting among young adults.J Adolesc Health. 2013; 52: 301-306Abstract Full Text Full Text PDF PubMed Scopus (198) Google Scholar]. These authors determined that indeed, sexting is popular among young adults, but is not necessarily correlated with riskier sexual behaviors.In the other study, the researchers suggest that sexting among young adults is robustly associated with high-risk sexual behaviors (substance abuse, unprotected sex, and sex with multiple partners) [[9]Herbenick E.G. Schick D.J. Sanders A.M. Bull S.S. et al.Sexting, substance use, and sexual risk behavior in young adults.J Adolesc Health. 2013; 52: 307-313Abstract Full Text Full Text PDF PubMed Scopus (246) Google Scholar]. However, this study did not recruit members of high-risk groups for participation in the research. A recent CDC report found that all 18- to 29-year-olds are not at the same risk of unprotected sex with multiple partners, even when drunk or high. Young adults of color and men who have sex with men are at significantly increased risk of contracting HIV during risky sex than their Caucasian peers and their male peers who only have sex with women [[10]Signs V. HIV infection, testing and risk behaviors among youths – United states. Centers for Disease Control and Prevention, 2012http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6147a5.htm?s_cid=mm6147a5_wGoogle Scholar]. In Benotsch's study, participants were recruited from a convenience sample of a first-year college psychology course at a large state university. Caucasian students were more likely to be sexting than nonwhite participants, and no participants were asked about their gender preferences in sex partners.Researchers in both studies posed a number of reasons young adults might be engaging in sexting, with the primary three being: 1)Sexting is a standalone safer sex practice.2)Sexting is a risky (and risqué) sexual behavior.3)Sexting is part of the repertoire of sexually active young adults in relationship. Further research might find that a combination of all three reasons lead young adults to use the technology at their fingertips for sexual pleasure. Even combined, these are not reasons we as a culture should use to spread fear of young adults' sexuality. If we are to use sexting to create relevant health messaging for youth, as Dr Benotsch and his co-authors recommend, the messages could focus less on shame and more on mutual consent, communication about sexual desires, and regular testing for HIV and other STDs, especially for sexually active members of high-risk groups. “The same thing happens repeatedly whenever a new technology is introduced into Western popular culture: It becomes an instrument with which to terrify ourselves and others about sex” [[1]Klein M. America's war on sex: the attack on law, lust and liberty. Praeger, Westport, CT2008Google Scholar]. In this quote, Dr. Marty Klein was speaking about the introduction of the Internet in the 90s; the same holds true for the mobile phone today. Mobile phones are ubiquitous in our culture, particularly among teens and young adults. Seventy-seven percent of teens aged 12–17 years own a cell phone, and 85% of people aged >18 years are cell phone owners as well [[2]Teen Gadget OwnershipThe Pew Research Center's Internet and American Life Project, 2011 Teen/Parent Survey.http://pewinternet.org/Static-Pages/Trend-Data-%28Teens%29/Teen-Gadget-Ownership.aspxGoogle Scholar]. With all the incredible uses of the mobile phone that have been implemented and those imagined, but not yet invented, what has the media been reporting on for the past 2 years? Sexting. Sexting describes sharing sexually suggestive photos and messages through cell phones and other mobile media [[3]Chalfen R. It's only a picture: Sexting, smutty snapshots and felony charges.Vis Stud. 2009; 24: 258-268Crossref Scopus (30) Google Scholar]. According to Gordon-Messer et al in this month's issue, sexting has indeed caused substantial fear over its legality and safety, both in the peer-reviewed literature and the mainstream press [4Diliberto GM, Mattey E, Sexting NASN School of Nursing 2009;24:263–7.Google Scholar, 5Katzman D.K. Sexting: Keeping teens safe and responsible in a technologically savvy world.Paediatr Child Health. 2010; 15: 41-42PubMed Google Scholar, 6Hoffman J. A girl's nude photo and altered lives. New York Times, March 26, 2011http://www.nytimes.com/2011/03/27/us/27sexting.html?pagewanted=allGoogle Scholar]. Much of the concern has been around teenagers and underage distribution of explicit materials. However, the two articles in this month's edition look at young adults aged 18–24 years, and the connections between sexting and health risk behaviors. Interestingly enough, one found connections between sexting and risky behaviors, and the other found no connections between sexting and sexual risk behaviors and psychological well-being. The greater question we need to ask, however, is why we are even starting from a place that sharing sexy pictures might be linked to unhealthy behaviors in young adults? Young adults are in the prime of their sexual lives. People aged 18–29 years have more sex (112 times per year) than any other age-group [[7]Herbenick D. Schick M. Sanders V. et al.Sexual behavior in the united states: Results from a national probability sample of men and women ages 14–94.J Sex Med. 2010; 7: 255-265Crossref PubMed Scopus (450) Google Scholar], and sharing of sexual pictures of people aged >18 years, between consenting adults, is protected under the first amendment. In one of the two studies, the researchers were able to debunk the fear-based myths that surround sex and technology, and risk-taking behaviors [[8]Gordon-Messer D. Bauermeister J.A. Grodzinski A. Zimmerman M. et al.Sexting among young adults.J Adolesc Health. 2013; 52: 301-306Abstract Full Text Full Text PDF PubMed Scopus (198) Google Scholar]. These authors determined that indeed, sexting is popular among young adults, but is not necessarily correlated with riskier sexual behaviors. In the other study, the researchers suggest that sexting among young adults is robustly associated with high-risk sexual behaviors (substance abuse, unprotected sex, and sex with multiple partners) [[9]Herbenick E.G. Schick D.J. Sanders A.M. Bull S.S. et al.Sexting, substance use, and sexual risk behavior in young adults.J Adolesc Health. 2013; 52: 307-313Abstract Full Text Full Text PDF PubMed Scopus (246) Google Scholar]. However, this study did not recruit members of high-risk groups for participation in the research. A recent CDC report found that all 18- to 29-year-olds are not at the same risk of unprotected sex with multiple partners, even when drunk or high. Young adults of color and men who have sex with men are at significantly increased risk of contracting HIV during risky sex than their Caucasian peers and their male peers who only have sex with women [[10]Signs V. HIV infection, testing and risk behaviors among youths – United states. Centers for Disease Control and Prevention, 2012http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6147a5.htm?s_cid=mm6147a5_wGoogle Scholar]. In Benotsch's study, participants were recruited from a convenience sample of a first-year college psychology course at a large state university. Caucasian students were more likely to be sexting than nonwhite participants, and no participants were asked about their gender preferences in sex partners. Researchers in both studies posed a number of reasons young adults might be engaging in sexting, with the primary three being: 1)Sexting is a standalone safer sex practice.2)Sexting is a risky (and risqué) sexual behavior.3)Sexting is part of the repertoire of sexually active young adults in relationship. Further research might find that a combination of all three reasons lead young adults to use the technology at their fingertips for sexual pleasure. Even combined, these are not reasons we as a culture should use to spread fear of young adults' sexuality. If we are to use sexting to create relevant health messaging for youth, as Dr Benotsch and his co-authors recommend, the messages could focus less on shame and more on mutual consent, communication about sexual desires, and regular testing for HIV and other STDs, especially for sexually active members of high-risk groups.

Youth, particularly youth of color, continue to face disparities with regard to sexually transmitted infections (STIs), including HIV. Yet, comprehensive education about sex and sexual risk for STIs is not universal for youth in the United States. While Internet research on HIV prevention has demonstrated that the medium can be as effective as face-to-face education and prevention approaches, Internet-based research has faced challenges in recruitment of diverse samples, has not consistently been able to retain adequate samples, and do so for long-term follow-up. Additionally, we have few examples of research on social networking sites, which are particularly popular with youth and represent locations where they spend the majority of their time online. In this work, we describe efforts to recruit and retain youth on My Space and Facebook for a randomized controlled trial testing the efficacy of using social media for HIV prevention. Findings demonstrate no success in using My Space to recruit for our STI prevention intervention, but success in recruitment of a diverse sample and short-term retention of this sample using Facebook. We recruited 1578 diverse youth aged 16-24 years for the study and retained 69% of them for a two-month follow-up; follow-up dropped to 50% at six months, demonstrating challenges with longer-term retention. This work represents innovation in recruitment and retention of individuals and networks using social media.

Youth bear a significant proportion of the sexually transmitted infection (STI)/HIV burden in the United States, CDC, 2010. Available at: http://www.cdc.gov/std/stats09/default.htm, with rates of some STIs increasing among youth of color and young men who have sex with men. Technology use among youth also continues to increase. The ubiquitous nature of technology use among youth offers a multitude of opportunities to promote youth sexual health and to prevent disease transmission and unplanned pregnancies. To date, there have been a handful of peer-reviewed articles published regarding the feasibility, acceptability, and effectiveness of using new media and technology for sexual health promotion. Despite recent publications, there is still a real need for high-quality research to understand the impact of different forms of new media use on youth sexual health, as well as to determine the best ways to harness technology to promote safer sex behaviors, both for the short- and long-term. In March 2011, Internet Sexuality Information Services (ISIS), National Institute of Mental Health (NIMH), and the Ford Foundation convened a meeting of scientists and technology experts to discuss how to effectively conduct sexual health promotion research using new forms of technology. The meeting was structured to cover the following topic areas: (i) research–community partnerships, (ii) institutional review board and ethical issues, (iii) theoretical frameworks, (iv) intervention approaches, (v) recruitment methods, and (vi) assessing impact. Presentations included case studies of successful technology-based HIV/STI prevention interventions for youth, which led to broader discussions on how to conduct research in this area. This article summarizes the meeting proceedings, highlights key points, offers recommendations, and outlines future directions.

New digital media (e.g., the Internet, text messaging, and social networking sites [SNS]) have dramatically altered the communication landscape, especially for youth. These communication platforms present new tools for engaging youth in sexual health promotion and risk reduction. We searched eight public databases across multiple disciplines for all peer-reviewed studies published between January 2000 and May 2011 that empirically evaluated the impact of digital media-based interventions on the sexual health knowledge, attitudes, and/or behaviors of adolescents aged 13–24 years. Of 942 abstracts, 10 met inclusion criteria. Seven studies were conducted in the United States. Eight described Web-based interventions, one used mobile phones, and one was conducted on an SNS. Two studies significantly delayed initiation of sex, and one was successful in encouraging users of an SNS to remove sex references from their public profile. Seven interventions significantly influenced psychosocial outcomes such as condom self-efficacy and abstinence attitudes, but at times the results were in directions unexpected by the study authors. Six studies increased knowledge of HIV, sexually transmitted infections, or pregnancy. This area of research is emerging and rapidly changing. More data from controlled studies with longer (>1 year) follow-up and measurement of behavioral outcomes will provide a more robust evidence base from which to judge the effectiveness of new digital media in changing adolescent sexual behavior.

Seroadaptive behaviors have been widely described as preventive strategies among men who have sex with men (MSM) and other populations worldwide. However, causal links between intentions to adopt seroadaptive behaviors and subsequent behavior have not been established. We conducted a longitudinal study of 732 MSM in San Francisco to assess consistency and adherence to multiple seroadaptive behaviors, abstinence and condom use, whether prior intentions predict future seroadaptive behaviors and the likelihood that observed behavioral patterns are the result of chance. Pure serosorting (i.e., having only HIV-negative partners) among HIV-negative MSM and seropositioning (i.e., assuming the receptive position during unprotected anal sex) among HIV-positive MSM were more common, more successfully adhered to and more strongly associated with prior intentions than consistent condom use. Seroconcordant partnerships occurred significantly more often than expected by chance, reducing the prevalence of serodiscordant partnerships. Having no sex was intended by the fewest MSM, yet half of HIV-positive MSM who abstained from sex at baseline also did so at 12 month follow-up. Nonetheless, no preventive strategy was consistently used by more than one-third of MSM overall and none was adhered to by more than half from baseline to follow-up. The effectiveness of seroadaptive strategies should be improved and used as efficacy endpoints in trials of behavioral prevention interventions.

oSeroadaptationo comprises sexual behaviors to reduce the risk of HIV acquisition and transmission based on knowing one's own and one's sexual partners' serostatus. We measured the prevalence of seroadaptive behaviors among men who have sex with men (MSM) recruited through time-location sampling (TLS) across three perspectives: by individuals (N=1207 MSM), among sexual dyads (N=3746 partnerships), and for sexual episodes (N=63,789 episodes) in the preceding six months. Seroadaptation was more common than 100% condom use when considering the consistent behavioral pattern of individuals (adopted by 39.1% vs. 25.0% of men, respectively). Among sexual dyads 100% condom use was more common than seroadaptation (33.1% vs. 26.4%, respectively). Considering episodes of sex, not having anal intercourse (65.0%) and condom use (16.0%) were the most common risk reduction behaviors. Sex of highest acquisition and transmission risks (unprotected anal intercourse with a HIV serodiscordant or unknown status partner in the riskier position) occurred in only 1.6% of sexual episodes. In aggregate, MSM achieve a high level of sexual harm reduction through multiple strategies. Detailed measures of seroadaptive behaviors are needed to effectively target HIV risk and gauge the potential of serosorting and related sexual harm reduction strategies on the HIV epidemic.

In the USA, Internet and mobile technologies have become integrated into our lives. An entire generation has grown up with new channels for gathering and sharing information and connecting with friends and like-minded people. This article will describe some of the technologies that are popular with youth today, together with case examples demonstrating how technology is being used for sexual and reproductive health. It concludes with advice for professionals in the field to stay abreast of new media and online and mobile technology while maintaining integrity, accuracy, and authenticity of voice to communicate effectively with youth around maintaining lifelong sexual health.

Methods of collecting behavioral surveillance data, including Web-based methods, have recently been explored in the United States. Questions have arisen as to what extent Internet recruitment methods yield samples of MSM comparable to those obtained using venue-based recruitment methods. We compare three recruitment methods among MSM with respect to demographic and risk behaviors, one sample was obtained using time location sampling at venues in San Francisco, one using a venue based like approach on the Internet and one using direct-marketing advertisements to recruit participants. The physical venue approach was most successful in completing interviews with approached men than both Internet approaches. Respondents recruited via the three methods reported slight differences in risk behavior. Direct marketing internet recruitment can obtain large samples of MSM in a short time.

Deb Levine and colleagues describe an innovative online e-card service for partner notification, initial evaluation results, and future research needs.

Objective: In response to the current syphilis epidemic among men who have sex with men, the San Francisco Department of Public Health sought to increase syphilis testing by offering testing in nonclinical settings.Goal: The goal of this study was to collaborate with a community-based organization, Internet Sexuality Information Services, Inc. (ISIS), to design an innovative, confidential, online testing service for syphilis.Study: The service, called STDTest.org, was launched in June 2003. The web site allows people to print out a laboratory requisition slip, have their blood drawn, and receive their test results online.Results: During the first year, 218 tests were performed and 13 persons had reactive serologies. Six patients were diagnosed with a new syphilis infection and treated.Conclusions: Online syphilis testing offers a free and convenient alternative to getting tested at the San Francisco municipal sexually transmitted disease clinic and an additional means for detecting syphilis cases.