Household Internet Access Research Articles

Spatial econometric analysis of the digital divide in Thailand at the sub-district level: Patterns and determinants

This study explores spatial patterns of the digital divide and its determinants at the sub-district level in Thailand, uncovering nuanced patterns often overlooked in the in prior literature. To our knowledge, no studies in the digital divide field have offered such detailed estimations. Based on the Spatially Aware Technology Utilization Model, we constructed a conceptual model tailored to the digital divide's geospatial context in Thailand. Using a spatial econometric approach, we analyzed the 2021 data set on basic household necessities provided by Thailand's Community Development Department. The results show a positive spatial autocorrelation of the household internet access divide (HIAD) across Thailand's sub-districts. This spatial clustering tended to be high–high in the sub-districts located in the northeastern and northern regions, with low–low agglomerations in the central region of Thailand. In addition, the spatial econometric analysis results indicated that the HIAD may be influenced by various factors including demographic, economic, educational, government ICT prioritization, social capital, transportation, and disaster-related variables. This study provides both theoretical and policy implications to enrich geographic knowledge of the digital divide, specifically in the context of developing countries.

IMPACT OF INFORMATION AND COMMUNICATION TECHNOLOGY ON THE DIGITAL ECONOMY

Purpose. The article explores the impact of Information and Communication Technologies (ICT) and their role and place in the dynamics of the digital economy. The aim of this research is to assess the impact of the digital economy on GDP per capita in EU countries. Methodology. Analysis of ICT as a key factor in enhancing economic growth through the implementation of digital technology opportunities. Panel data from Eurostat and the World Bank covering EU countries from 2014 to 2021 were used for analysis. A correlation analysis was then conducted between variables, and the model was relevant for forecasting. Results. The number of studies on the impact of Information and Communication Technologies on the economic growth of countries has increased in recent years. However, there is still no assessment of the real GDP impact on the level of household Internet access in the EU area. Studying this gap in the literature allows us to draw conclusions about the implications for stakeholders regarding more effective implementation of the digital agenda. Scientific novelty. The digital economy, measured by Internet, mobile phone, and fixed broadband access, influences the economic growth of a country. This, in turn, depends on the level of technology measures covering the digital economy. ICT positively influence the development of countries' economies and can be used as tools by stakeholders. These agents should generate policies that enhance ICT technological infrastructure, digital empowerment of the population, and greater access to ICT. The GDP level model is presented as a function of Internet access for households in the EU area along with a short-term forecast for this index. It is shown that investments in ICT infrastructure are indispensable for the development of a strong knowledge- and digital technology-based economy. Practical significance. The research results will help in identifying opportunities and levers of influence for governmental institutions and other socio-economic systems on the impact of digital economy development processes on GDP per capita in EU countries.

Disparities in access to healthcare services in a regional neonatal transport network

IntroductionThe disproportionate distribution of healthcare resources in the U.S. leads to an annual estimated 68,000 critically-ill newborns transported to regional centers for intensive care. As described in the Systems Engineering Initiative for Patient Safety (SEIPS) 3.0 framework, patients with limited access to healthcare experience multiple healthcare settings in their journey to specialty care. Little is known about community resources for transported neonatal patients in the Pacific Northwest region. MethodsTransport data from January 2014–December 2019 identified referral zip codes for transfers to a regional neonatal intensive care unit (NICU). Using the SEIPS 3.0 framework to explore the journey of families experiencing neonatal complications, we linked referral zip codes to data on healthcare and resource access including: Health Transportation Shortage Index (HTSI); US Census Small Area Income and Poverty Estimates; public transportation availability; Health Professional Shortage Area (HPSA) and number of Federally Qualified Health Centers. Results1834 neonatal transports from 75 zip codes were analyzed. Forty percent of patients were transferred from a HPSA, one-quarter from areas with limited public transit availability (28%) and household internet access (24%). Almost all infants transferred from a high HTSI area (96%) were transported by air. ConclusionMany patients were referred from communities with high poverty and limited services. Improving patient outcomes requires population and policy level recommendations and care coordination between healthcare organizations and community services. Considering the patient family perspective within the SEIPS 3.0 framework will ensure patient centered care and an inclusive experience for families transitioning through healthcare settings.

GIS-based model for the assessment of the smart sustainable development of municipalities of Northeast Bulgaria

In recent years, Bulgarian municipalities have introduced smart development systems. The Bulgarian state is at the top of the world rankings regarding household internet access and connection speed. The authors develop and validate a GIS-based model for the analysis and evaluation of sustainable cities. The authors conclude that in a global digital economy and society, Bulgarian regions need to improve the accessibility of WI-FI networks to meet the challenges of Smart Development. In recent years, the authors have observed a growth of Smart Cities initiatives in large areas of Northeast Bulgaria. However, Bulgarian municipalities in the study area are lagging in deploying smart governance systems.

Addressing the Digital Divide: Access and Use of Technology in Education

The digital divide, characterized by disparities in access to and use of technology, presents a significant challenge in education. This study aims to investigate the impact of the digital divide on students' access to technology and its influence on their educational outcomes. A quantitative research methodology was employed, with a sample size of 400 students from diverse educational backgrounds. The study utilized survey questionnaires to gather data on internet access, device ownership, and technology use in education. The findings revealed variations in internet access across different age groups, with younger individuals having higher levels of access compared to older age groups. Additionally, disparities in household internet access were observed between rural and urban areas, with rural areas experiencing lower connectivity. Gender-based differences in personal device ownership were also evident, highlighting potential gender-related digital divides. Moreover, students from low-income households faced lower levels of internet access, indicating a socioeconomic divide in technology access. Additionally, the study emphasizes the importance of establishing technology resource centers in schools and fostering public-private partnerships to bridge the technology gap in education. The study contributes to the existing body of knowledge by providing insights into the digital divide and offering recommendations for addressing this issue in the field of education.

Revisiting Economic Hardship in a National Sample of Adolescents With and Without Disabilities: A Conceptual Replication

The purpose of the current study was to conceptually replicate a multi-indicator construct of economic hardship in a national sample of adolescents with and without disabilities ( N = 9,230). Using data from the National Longitudinal Transition Study 2012 (NLTS2012), the latent construct economic hardship was confirmed from six theoretically relevant indicators: household income, parent education level, parent employment status, one- or two-parent household, household internet access, and participation in government-assisted social programs (e.g., Supplemental Security Income benefits, Supplemental Nutrition Assistance Program, Temporary Assistance for Needy Families). In addition, we examined group differences on the latent mean of economic hardship based on disability category, race and ethnicity, and school and family factors. Mean differences showed significantly lower economic hardship for youth on 504 plans, youth with autism, and for White non-Hispanic youth; whereas there was significantly greater hardship for youth with intellectual disability and youth with emotional disturbance and among youth of color. The implications of the replicated and expanded findings for adolescents with and without disabilities are discussed.

Factors associated with comorbidity for depression, anxiety, and stress screening in a sample of a Brazilian university’s community during Covid-19 pandemic

Backgrouund: Mental health is a major public health challenge wordwide and affected people may present more than one mental outcomes simultaneosly. Purpose: To describe the prevalence of comorbidity in screening for depression, anxiety, and stress, as well as determinants of these comorbidity in a university’s community in Mid-West Brazil during the Covid-19. Methods: A cross-sectional descriptive/exploratory study used self-report DASS-21 to screen for mental health. Data from a non-probabilistic sample was obtained online between April 10 and May 25, 2020. Multinomial model was used to identify factors associated with comorbidity. Results: The majority of the sample was students (78.84%), women (65.53%), white (54.18%), single (71.33%), aged 18-29 years old (67.26%), with an overall mean age of 28.3 years (sd = 10.1), 85.63% refered household internet access. 14.48%, 12.42%, and 31.12% screened positive for one, two and all the 3 outcomes, respectively. Students, having children, substance use, presenting Covid-19’s symptoms, worsened self-rated emotional state, and previous mental disorders were associated with comorbidity for depression, anxiety, and stress. Conclusions: Individuals from the studied university’s community experienced psychological disorders, as measured by levels of anxiety, depression, and stress and comorbidity for these outcomes, probably as Covid-19’s initial psychological impact.

Explaining Connectedness: An Exploration of the Factors Affecting Internet Access in India

Access to the internet can promote education, upskilling, human capital, and national and international economic outcomes. However, the household internet access rate in India in 2011 was 10.1% (Roser et al., 2015). Using data from the 2011 Indian Census, this study analyses the impact of computer access, area, literacy, and working rates alongside a gender perspective to explain district-wise household internet access. The analysis demonstrates that access to computers, area, male activity, and literacy significantly explain the internet access rates observed in Indian districts. The study concludes that socio-demographic factors influence the internet uptake and digital divide in India. The conclusion of this paper contributes to theoretical discussions of the digital divide in the modern history of India and provides implications for policy and market expansion in India.

STRUCTURAL EQUATIONS MODELING OF THE DIGITALIZATION PROCESS INFLUENCE ON THE DEVELOPMENT OF THE EDUCATIONAL SERVICES MARKET

The educational services market functions under the influence of numerous factors that have both direct and indirect effects on it. In today's conditions, they primarily include the digitalization process, the characteristic feature of which is its impact on all spheres of social life, and the educational services market is no exception. The digitization process ensures the formation of the necessary digital competencies in the population and the employment of qualified personnel in the field of IT. The question of researching the impact of the digitalization process on the development of the educational services market is becoming more and more relevant and is especially acute in the conditions of the COVID-19 pandemic and the Russian invasion of Ukraine. The information base of the conducted research is official statistical data of Eurostat and the European Commission, analytical reports and scientific publications of domestic and foreign authors regarding the connection between the digitization process and the development of the educational services market. In the countries of the European Union, the digitalization process is an integral element of their development, its strategic orientations are defined in the document “Digital Compass 2030: The European Path of the Digital Decade”, which aims to the improvement of digital capabilities in infrastructure and education, as well as in the digital transformation of business and public services . The study was conducted on the dataset of indicators of 27 European countries characterizing the digitalization process and the development of the educational services market in 2021, by modeling structural equations using the PLS-SEM partial least squares method. The results of the conducted research confirmed the existence of a statistically significant positive impact of the digitization process on the development of the educational services market as a whole at the level of the structural model. Such indicators as the level of household Internet access, the employment of IT specialists, state financing of education, and the share of the population with higher education are statistically significant and relevant within the measurement models. Taking into account the European integration vector of Ukraine's development, the research results can be used to harmonize the process of digitalization of the economy and the transformation of the educational services market of Ukraine, in particular in the direction of expanding the level of access to the Internet and stimulating employment in the IT sphere.

Molecular Biomarker and Programmed Death-Ligand 1 Expression Testing in Patients With Advanced Stage Non-small Cell Lung Cancer Across North Carolina Community Hospitals

Precision medicine in advanced non-small cell lung cancer (NSCLC) requires molecular biomarker testing in patients with nonsquamous and select patients with squamous histologies, and programmed death-ligand 1 (PD-L1) testing in both. What are rates of molecular and PD-L1 biomarker testing in patients with advanced NSCLC in community practices, and do rates vary by sociodemographic factors? What is the prevalence of molecular biomarker mutations and PD-L1 expression levels? From 389 stage IV NSCLC pathology reports obtained through the University of North Carolina Lineberger Comprehensive Cancer Center's Rapid Case Ascertainment Program from 38 community hospitals across North Carolina, we abstracted demographics, histology, molecular biomarker testing and results, and PD-L1 testing and expression. We geocoded patient and hospital addresses to determine travel time, distance to care, and census block level contextual variables. We compared molecular biomarker and PD-L1 testing rates, the prevalence of molecular biomarkers, and PD-L1 expression levels by race and sex, using χ2 tests. We determined predictors of testing, using multivariable logistic regression and report adjusted ORs and 95%CI. Among patients with nonsquamous NSCLC, 64.4%were tested for molecular biomarkers, and among all NSCLC patients 53.2%were tested for PD-L1 expression. Differences in biomarker testing rates by sociodemographic factors were not statistically significant in univariate or adjusted analyses. Adjusted analyses showed that patients living in areas with higher household internet access were more likely to undergo PD-L1 testing (adjusted OR= 1.66, 95%CI, 1.02-2.71). Sociodemographic differences in molecular biomarker prevalence and PD-L1 expression levels were not statistically significant, except for human epidermal growth factor receptor 2 (HER2) mutations, which occurred in 16.7%of males vs0%in females, P= .05. Biomarker testing remains underused in NSCLC. Future work should include larger populations and evaluate hospital-specific testing protocols to identify and address barriers to guideline-recommended testing.

Investigating the Academic Performance and Disciplinary Consequences of School District Internet Access Spending

Public school districts not only make strategic investments in internet access as a means to attract and retain students but also communicate the value of these investments with parents as part of their marketing programs. While it helps attract more customers, how does school district internet access spending (SDIAS) affect academic performance and disciplinary problems among students? Using a longitudinal data set that combines SDIAS of 1,243 school districts with academic performance and disciplinary records of more than 9,000 Texas public schools between 2000 and 2014, the authors find that a one-standard-deviation increase in SDIAS (an average increase of $.6 million) is associated with an improvement in eight academic performance indicators, with effect sizes ranging from 2% to 5% of a standard deviation, amounting to a $.8 million to $1.8 million increase in cumulative income for the current students of a school district. Furthermore, a one-standard-deviation increase in SDIAS is associated with a 5% increase in Part II offense–related school disciplinary problems, amounting to a yearly cost of $25,800 to $53,440 for a school district. The positive and negative consequences of SDIAS are more pronounced among schools in regions with a higher level of household internet access.

The written and unwritten rules of internet exclusion: inequality, institutions and network disadvantage in cities of the Global South

ABSTRACT Studies about the link between income and Internet access tend to focus exclusively on the demand side, or, when considering the supply side, to neglect any possible role of local and informal institutions. This research pays attention to the relationship between income distribution and Internet access within metropolitan areas of the Global South, with a special emphasis on local and informal institutions that could shape the ways by which this relationship works. Using a mixed-methods approach, two Latin American metropolitan areas are analysed: Santiago (Chile) and Medellín (Colombia). Although income is clearly linked to household Internet access in both cases, there are supply-side differences that can influence the income-connectivity nexus. The author proposes to introduce the concept of ‘institutionally generated network disadvantage’. Examples of formal and informal institutional factors are redlining, informal housing, socio-spatial segregation, tax exemptions and local public provision of services. The urban poor seem to be the most affected by institutionally generated digital exclusion.

Has the Promise of the Internet Been Realized? Internet Access and Collective Invention among Independent and Organizational Patent Inventors

The Internet provides individuals with new avenues for knowledge sharing and collaboration, two key ingredients for the production of novelty. Despite the unprecedented access to information and potential collaborators provided by the Internet, however, organizations remain the preeminent site of invention, presumably due to the tremendous resources, technology, and expertise at their disposal. Given the presumption that improved access to the Internet cultivates connectivity and novelty among individuals, on one hand, and the resources organizations can leverage to create novelty, on the other hand, we ask whether Internet access plays a role in the incidence of collective invention for independent inventors and organizational inventors in the knowledge economy. Regression models based on a sample of metropolitan areas in the United States predict that increases in household Internet access increases collective invention for organizational patent inventors, but not independent patent inventors.

Sociodemographic characteristics of young people using internet cafés

Objective: The internet is a major phenomenon of today’s society since it gives easy access to information. Internet use is becoming increasingly widespread and area of use has been expanding. Based on figures from Turkish Statistical Institute, home internet access was 41.6% in 2010 and increased to 83.8% in 2018. Despite increases in household internet access, use of internet cafés is also on increase. The aim of the present study was to determine the sociodemographic characteristics of young people using internet cafés and the reasons why they prefer using internet cafes. Method: The study was carried out on internet cafés registered by Tokat Health Provincial Directorate. Written consent was taken from participants and sociodemographic data questionnaire prepared by the investigators was completed by all subjects. Results: All participants and interviewed people were male. Average age of the participants was 20.1±2.34. Forty-two of them (70%) had home internet access, while 18 (30%) did not. The main reason for using internet café was playing online games (42 participants, 70%). The participants mentioned that they used internet cafés 2-30 days in a month and 1-16 hours on a day. Conclusions: In the present study dealing with the sociodemographic data of young people using internet cafés, it was found that people younger than 24 years prefer using these cafes and they could spend considerable amount of time and money there. In addition, which web sites were visited and which online games were played by young people, how often and how long they used these public places were also questioned.

Bridging or Deepening the Digital Divide: Influence of Household Internet Access on Formal and Informal Volunteering

The digital divide persists; a quarter of the U.S. population is unconnected, left without Internet access at home. Yet volunteer recruitment is increasingly moving online to reach a broader audience. Despite widespread use, little is known about whether the lack of digital access has repercussions on connections offline in the community. We examine the influence of access on volunteering across four critical aspects—structure, time devoted, level of professionalization, and pathways to volunteering. We find home Internet access has an independent influence on volunteering even after controlling for socioeconomic status. Those with access are more likely to volunteer, formally and informally, and are more likely to become volunteers because they were asked. However, digitally unconnected volunteers devote more time. Nonprofit organizations and government agencies should be strategic and inclusive in their volunteer recruitment efforts to ensure they recruit qualified and dedicated volunteers rather than rely solely on digital recruitment strategies.

Parcel locker systems in a car dominant city: Location, characterisation and potential impacts on city planning and consumer travel access

Automated systems enabling customers to pick-up e-purchased goods from designated 24 h Parcel Locker pick-up points are proliferating. While they offer the promise of improved access to goods and reduced travel for consumers and delivery vehicles, the integration of these systems in cities, and their impact on access, generally and by mode are understudied.This paper explores the development, site characteristics and regional location characteristics of Parcel Lockers in five South East Queensland (SEQ) cities, Australia, and discusses implications for urban and transport planning in a car-oriented city.Micro level site analyses for 45 locker locations provide information on facilities (e.g. access by modes and universal accessibility, ground level, tenure type, safety). Hierarchical cluster analysis helps identify categories of locations. Suburb-level census and land use data as well as distance from transportation infrastructure and other Australia Post facilities were gathered and used to compare regional suburbs with and without Parcel Lockers. Logistic regression identifies the suburb level characteristics associated with the presence of a Parcel Locker (n = 273).Parcel Lockers in Brisbane are generally located at Australia Post locations, on commercial streets, shopping centres, suburban arterials and industrial parks. Automobile access and nearby parking is nearly ubiquitous, whereas alternative transport access is limited. Though site locations are constrained by commercial decisions, proximity to highways, to public transport, population density, a good balance of jobs and population, and higher rates of household Internet access are associated with the presence of a Parcel Locker.Documenting and assessing site characteristics and regional location of Parcel Lockers can help ensure its optimal and adequate integration and distribution across the region to satisfy city and transport planning goals. In its current state, Australia Post's Parcel Lockers partially meet the objectives of a sustainable city.

State policy action on Medicaid telemedicine reimbursement laws

ObjectiveThe spread of Medicaid telemedicine is limited due to the lack of comprehensive provider reimbursement laws. As federal legislation for insurance coverage lags behind its demand, states have taken the lead by passing tele-Medicaid reimbursement policy; yet, states vary on levels of comprehensiveness to cover all Medicaid providers, telemedicine technology, and service sites. This lack of uniformity creates a fragmented tele-Medicaid environment. The objective of this study is to explore state factors that predict policy adoption of comprehensive tele-Medicaid insurance reimbursement laws. MethodsWe use multivariate regression analysis and state-level data and control for political, socioeconomic, and demand factors. ResultsOrdered logistic regression analysis shows that states with greater household Internet access rate and a greater number of rural health clinics are more likely to pass comprehensive Medicaid telemedicine reimbursement laws. States with a greater history of adopting health insurance reform policies (not requiring technology for support) are not as likely to pass tele-Medicaid reimbursement laws that require technology. ConclusionComprehensive tele-Medicaid reimbursement laws are more likely to be adopted in states with a greater Internet technology capacity, and greater rural clinic infrastructure. States who have previously passed innovative health insurance policies are not adopting the tele-Medicaid insurance laws.

Differences in media access and use between rural Native American and White children

Native American children experience greater disparities in the number and magnitude of health-related diseases than White children. Multimedia-based health interventions may afford valuable opportunities for reaching this underserved demographic; however, limited data are available describing the use of media technologies among Native Americans. This study characterized diverse media access and use between rural Native American and White children. Surveys were administered to students (n=477) aged 10-15 years in grades 6-8 across four public middle schools in the rural Upper Peninsula of the Midwestern USA state of Michigan. Native American children (n=41) were more likely than White children (n=436) to have a video game system in their bedroom (65.9% vs 45.4%; p=0.01) and watch more minutes of television on Saturdays (110.3±91.7 vs 80.7±80.8; p=0.03). Native American children also had fewer computers within the home (1.20±0.81 vs 1.68±1.21; p=0.01) than White children and less household internet access (75.6% vs 87.1%; p=0.04), but demonstrated more use in minutes after school (79.9±97.9 vs 51.1±71.6; p=0.02) and on Saturdays (92.6±107.4 vs 60.0±85.1; p=0.02). This represents the first cross-cultural comparison of media access and use between Native American and White children from rural Michigan. Greater computer and internet use observed among the Native American children surveyed in this study supports the use of web-based public health initiatives aimed at reducing health disparities within this vulnerable group.

Video Content in Web Surveys: Effects on Selection Bias and Validity

One of the benefits of web-based research is the capacity to deliver video content directly to individual survey participants. However, yet to be investigated is whether the participant demographic and attitudinal characteristics are distorted when respondents are asked to view and respond to videos on their personal computers. To address this question, this research paper focuses on two potential types of selection bias introduced into web-based studies with video content: (1) that resulting from respondents� differential ability to view videos; and (2) that resulting from demographic and motivational influences of adequate exposure to video content. Through a secondary analysis of two studies focusing on adult cigarette smokers living in the United States, this research paper investigates whether the ability to view videos differs between demographic groups, whether respondents who do not view videos for their full duration differ from those who view videos for an appropriate amount of time, and whether video characteristics influenced this relationship. Results show that age, education, sex, household internet access, and work status influence the likelihood of a respondent reporting an inability to view videos. In addition, age, employment status, and congeniality of and interest in issue topic affect adequate video viewing times. These outcomes suggest that although web-based studies offer many advantages, the inclusion of videos within these surveys has the potential to undermine the accuracy of study findings and distort the representative nature of the study sample. Recommendations for minimizing potential distortions are presented

Estimating the size of the MSM populations for 38 European countries by calculating the survey-surveillance discrepancies (SSD) between self-reported new HIV diagnoses from the European MSM internet survey (EMIS) and surveillance-reported HIV diagnoses among MSM in 2009

BackgroundComparison of rates of newly diagnosed HIV infections among MSM across countries is challenging for a variety of reasons, including the unknown size of MSM populations. In this paper we propose a method of triangulating surveillance data with data collected in a pan-European MSM Internet Survey (EMIS) to estimate the sizes of the national MSM populations and the rates at which HIV is being diagnosed amongst them by calculating survey-surveillance discrepancies (SSD) as a measure of selection biases of survey participants.MethodsIn 2010, the first EMIS collected self-reported data on HIV diagnoses among more than 180,000 MSM in 38 countries of Europe. These data were compared with data from national HIV surveillance systems to explore possible sampling and reporting biases in the two approaches. The Survey-Surveillance Discrepancy (SSD) represents the ratio of survey members diagnosed in 2009 (HIVsvy) to total survey members (Nsvy), divided by the ratio of surveillance reports of diagnoses in 2009 (HIVpop) to the estimated total MSM population (Npop). As differences in household internet access may be a key component of survey selection biases, we analysed the relationship between household internet access and SSD in countries conducting consecutive MSM internet surveys at different time points with increasing levels of internet access. The empirically defined SSD was used to calculate the respective MSM population sizes (Npop), using the formula Npop = HIVpop*Nsvy*SSD/HIVsvy.ResultsSurvey-surveillance discrepancies for consecutive MSM internet surveys between 2003 and 2010 with different levels of household internet access were best described by a potential equation, with high SSD at low internet access, declining to a level around 2 with broad access. The lowest SSD was calculated for the Netherlands with 1.8, the highest for Moldova with 9.0. Taking the best available estimate for surveillance reports of HIV diagnoses among MSM in 2009 (HIVpop), the relative MSM population sizes were between 0.03% and 5.6% of the adult male population aged 15–64. The correlation between recently diagnosed (2009) HIV in EMIS participants and HIV diagnosed among MSM in 2009 as reported in the national surveillance systems was very high (R2 = 0.88) when using the calculated MSM population size.ConclusionsNpop and HIVpop were unreliably low for several countries. We discuss and identify possible measurement errors for countries with calculated MSM population sizes above 3% and below 1% of the adult male population. In most cases the number of new HIV diagnoses in MSM in the surveillance system appears too low. In some cases, measurement errors may be due to small EMIS sample sizes. It must be assumed that the SSD is modified by country-specific factors.Comparison of community-based survey data with surveillance data suggests only minor sampling biases in the former that – except for a few countries - do not seriously distort inter-country comparability, despite large variations in participation rates across countries. Internet surveys are useful complements to national surveillance systems, highlighting deficiencies and allowing estimates of the range of newly diagnosed infections among MSM in countries where surveillance systems fail to accurately provide such data.