But if the Internet is part of the problem, it's also part of the solution, say health advocates, including the CDC. "Typically, when we identify high-risk venues, the next step is to go to those high-risk venues and provide information and resources to make sure they're as safe as can be. It's not different with the Internet," says Dr. Ronald Valdiserri, deputy director of the CDC's National Center for HIV, STD and TB Prevention. "Public health workers have gone into bathhouses and bars to try to reach out to sexually active gay and bi men, and now we're just transferring the same kind of activities into these new venues." He mentions that Internet service providers such as AOL have been willing to place free banner ads about STDs in chat rooms; gay personals sites such as Manhunt.net have evidently been willing to do the same. Health departments have also been able to work with chat room providers to notify users of specific STD outbreaks without compromising their anonymity.

The Internet also offers a mode of communication both more distant and direct than face to face or phone to phone. InSPOT.org's electronic postcards, for their part, take the place of a touchy conversation -- a conversation that might otherwise not take place at all. When it comes to certain partners, "you may be very intimate with them but have no desire to chat with them, especially to give them such highly charged information," says Albert Hilgart, an Internet user-experience specialist who is a member of inSPOT.org's community advisory board. What the site offers, he says, is "a way to talk about it without talking about it."

Klausner concurs. While you can add a personal message to the card (and the site offers some guidelines), you don't have to. "People don't have to struggle with language. It's set up right there for people to inform others from the privacy of their home."

A couple of the six card options are worded casually but plainly: "Heads up ... I caught an STD since we messed around and you might have too. Please take care of yourself." Others are more irreverent -- "It's not what you brought to the party, it's what you left with" -- and that's also part of the plan. The goal is not only to provide a palette of choices (including serious ones) for different personality types but also to use humor to chip away at the stigma associated with STDs (much the same way condoms were marketed with funny novelty packaging in the 1980s, to help them go from ickily clinical to collect-'em-all cool.)

InSPOT.org users also needn't fear that Big Brother will somehow be able to print out a list of card senders, as the site does not capture such data in the first place. What about the risk of someone misusing the site to send an e-card as a "joke"? Says Knapper: "The advisory board struggled and thought hard about how the site could be misused." Ultimately, they simply posted very clear community guidelines that they trust will help build, he says, "a culture that makes people think this isn't something to be played around with." Adds Levine: "We are relying on the goodness of human nature."

The increase in STDs has caused other cities and organizations to get creative, too -- whether the focus is partner notification or other ways of shortening the distance between potentially affected people and testing or treatment. In Denver and elsewhere, some clinics use "patient-delivered partner therapy," in which a physician may give a patient (usually one with chlamydia) extra treatment drugs to take home to a partner. In Seattle, some pharmacies have agreed to do the same. (These approaches are legal only in certain states. California was the first state to legalize patient-delivered therapy.)

Still, among health advocates, effective notification remains a primary goal. "The standard way of dealing with partner notification leaves a lot to be desired. It's very important because it's a major impediment in dealing with the spread of STDs," says Dr. Kees Rietmeijer, director of the STD control program at the Denver Public Health Department. That's why, he says, "this field is really moving. There are a lot of people thinking about it and coming up with interesting ideas. And San Francisco is at the forefront."

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