Background Few studies have examined the association between sexual health risks and online sex seeking among teenagers. The purpose of this study was to assess the associations between meeting sex partners online and a range of sexual risk behaviours and outcomes among adolescents.

Methods Participants aged 13–19 years were recruited from a publicly funded teen clinic in Florida. After obtaining informed consent/assent, 273 participants completed an audio computer-assisted self-interview (ACASI) that included questions on demographics, sexual behaviour, STD history, and online sex-seeking behaviours and experiences. Participants also provided urine samples for chlamydia and gonorrhoea testing. Data were analysed using logistic regression to identify the association between having an online sex partner and sexual behaviours/outcomes.

Results After adjusting for significant bivariate correlates, teens reporting online sex partners were more likely to be male, be multiracial, have a history of same-sex sexual activity, report a higher number of vaginal sex partners, and report a lower age at first vaginal sex. However, teens with online sex partners were no more likely to have ever had an STD or a current biological STD.

Conclusion This study is one of the first to link biological STD results to online sex-seeking data in a youth population. While meeting a sex partner online was not associated with past or current STDs, it was associated with other sexual risk behaviours. Future research is needed to examine the complex nature of online sexual partnering among adolescents and to develop intervention approaches. In-depth qualitative interviews, currently being conducted with teens, are exploring the process and context of meeting partners online. These interview data will also be discussed in light of the ACASI and biological STD data findings.