Cruise Control

For public health advocates, the Internet, and its ability to spread disease through anonymous sex hookups, is the new tobacco. Just as the "right to smoke" as an important civil liberty has been largely discredited, the "right" of sex Web site owners to profit unfettered from the spread of diseases such as syphilis and AIDS should also go by the wayside.

Consider the parallels. Nicotine stimulates the brain's pleasure centers and temporarily eases stress. Cigarettes, lighters, ashtrays, and smoking porches serve as social props, making it easier for some people to connect with each other.

On the Internet, sites such as Adam4Adam encourage browsers to fill out questionnaires stating their body type, sexual preference, and physical location. They are immediately directed to pages with photos of dozens of men with hard abs and penises who are ready to have sex at a moment's notice.

If you're willing to click on a photo, send a quick proposition, and walk a couple of blocks, it's a snap to pile into an anonymous barebacking threesome and thus, presumably, enjoy some pleasure and temporarily ease stress.

Tobacco offers a clear trajectory toward illness, incapacity, and death. If you become a heavy smoker as a teenager, you have a 50-50 chance of it killing you.

Unlimited, anonymous, multipartnered sex of the sort encouraged and facilitated by Adam4Adam is also a route to serious illness. After nearly being eradicated in the late 1990s, syphilis — which if left untreated can cause brain and heart damage — bounced back with a vengeance in San Francisco from 1998 to 2002, increasing 1000 percent. It's now surging nationwide. A state health study released last month showed that new syphilis patients were most likely to have met new sex partners on the Internet. In San Francisco, more than two-thirds of patients surveyed by the Department of Public Health said they met new partners online — and at least half of those met on Adam4Adam.

Big Tobacco escaped significant regulation for 50 years by creating a multi-billion-dollar apparatus to influence politicians, create public sympathy, and conduct phony science.

Web sites such as Adam4Adam, AOL, and Craigslist have even more powerful weapons to use against public health regulators. They include the First Amendment, the secrecy-friendly structure of the Internet, and civil-liberties advocates suspicious of any threat to unfettered private activity online.

It's "protect public health versus make money vs. assure civil liberties," says Jeff Klausner, San Francisco's director of STD prevention and control. Over the past few weeks, Klausner has been working with the city attorney, the National Institutes of Health, the California Department of Public Health, and the Department of Public Health in New York, whose large gay community also uses social networking sites for sex, in an effort to track down Adam4Adam's thus-far-anonymous and secretive owners. His aim: To get the site to slap the equivalent of a surgeon general's warning on its hookup forums and at least make users aware of the dangers of the anonymous, multiple-partner unsafe sex that is its stock-in-trade.

Adam4Adam purposefully obscures its ownership with a private-registration service called Domains by Proxy. The company has not responded to messages Klausner sent to a fax number and e-mail address on the site.

In response to my inquiry, someone identifying himself as Marc replied to say Adam4Adam had been running a banner ad for the Department of Public Health HIV vaccine trial, and directed me to a "health resources" page that listed five Web sites for groups combating AIDS and other STDs. "I can't even remember when we started that banner, it's been so long," he said.

"That's an HIV vaccine campaign," Klausner retorts. "It has nothing to do with sexual health, safe sex practices, or anything that I've been trying to talk to them about. Maybe they could also inform members how common STDs are, that they're asymptomatic, and inform them where they could get a checkup." Klausner has considered the possibility of a public nuisance lawsuit against Adam4Adam, although it might be legally impractical, considering that the company apparently isn't located in the city.

In his efforts to crack down on sites like Adam4Adam, Klausner gets no sympathy from civil-liberties advocates. "We've been through this before when people try to shut down newspapers as public nuisances," says Lee Tien, an attorney with the Electronic Frontier Foundation, a nonprofit dedicated to protecting individuals' rights online. "The First Amendment protects the press, it protects online speakers, it protects AOL, and it protects sex Web sites."

To me, however, this seems one of those instances where the residents of America's civil-liberties capital need to step back. Let's think of the real stakes: the risk of rampant disease, disability, and death versus infringement of the right of Web site owners to remain anonymous as they make money off customers' tastes for reckless, anonymous sex.