How do digital platforms impact sexual health?
Prevention messaging
Access to STI testing services
Pre-exposure prophylaxis
Adherence to medication
Artificial intelligence for STI management
References
Further reading
Sexually transmitted infections (STIs) are spread from one person to another through sexual contact, including vaginal, oral, and anal sex. Of more than 30 pathogens that are transmitted sexually, eight are associated with the highest incidence of STIs.
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Among these pathogens, syphilis, gonorrhea, chlamydia, and trichomoniasis cause curable infections, whereas hepatitis B, herpes simplex virus (HSV), human immunodeficiency virus (HIV), and human papillomavirus (HPV) cause incurable infections. More recently, monkeypox, Shigella sonnei, Neisseria meningitidis, Ebola, and Zika have been identified as sexually transmitted pathogens.
Globally, more than one million STIs are acquired every day. Most of these infections remain asymptomatic, which increases the risk of unintentional disease transmission. Each year, about 374 million new STIs are caused by one of four treatable pathogens.
How do digital platforms impact sexual health?
Digital health provides a powerful and effective platform for the prevention and management of STIs. Digital platforms can be used to develop online social networks through individual-level or community-level connections.
Advanced technology and increased availability and accessibility to internet services have made digital platforms an integral part of our lives. Public health authorities are now adopting and applying various features of digital platforms to increase awareness and improve sexual health services. In the modern healthcare system, digital health is considered a promising approach for disease surveillance and public health interventions.
The use of digital platforms for better management of STIs and to control their spread is now increasing worldwide.
Prevention messaging
Consistent use of condoms is the most effective way of preventing STIs. Digital platforms are considered very useful for promoting condom use among young adults. Many messaging strategies, including peer-led, theory-based, and crowdsourcing interventions, have been developed.
In peer-led digital intervention, social media users with large numbers of followers are recruited as peer leaders to spread awareness about STI preventive measures among their peers. This intervention has been applied to secondary schools to prevent STI/HIV transmission and improve sexual health in secondary schools (STASH) by recruiting the most influential students.
Theory-based digital interventions involve behavioral theories to guide their implementation. Various theories have been implemented in digital interventions, including health belief models, the theory of planned behavior, protection motivation theory, and the unified theory of behavior. New digital interventions for sexual health education have been developed using these theories.
Researchers have utilized unified theory of behavior to compare different message delivery tools, including short messaging systems, web-based desktop chatting, and mobile phone chatting.
Crowdsourcing is another novel intervention that is used to scale up the engagement of target populations on digital platforms by encouraging passive participants to contribute to the intervention actively. Evidence indicates that it is an effective and low-cost strategy to improve condom use among at-risk populations.
Access to STI testing services
Recent advancement in digital technologies has allowed the use of digital platforms to increase the overall accessibility, availability, appropriateness, acceptability, and applicability of STI testing services. Digital platforms have also allowed patients to have online medical consultations to increase the adequacy and appropriateness of STI testing access. WeCare is a digital intervention that utilizes Facebook, texting, and GPS-based mobile social and sexual networking applications to increase STI healthcare outcomes.
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Channels provided by digital platforms are used to facilitate communications between vulnerable populations and initiate offline visits. An MSM (men who have sex with men)--friendly physician finder function embedded within a gay mobile app has been found to gain popularity among young people as an option to consult physicians online. This subsequently can increase patients’ access to STI information and facilitate STI testing or treatment-related decision-making.
Pre-exposure prophylaxis
Digital platforms are used to promote pre-exposure prophylaxis (PrEP) uptake. At-risk people consume this medication to prevent the contraction of STIs. Many studies have used social media platforms to educate people about PrEP and encourage them to use it.
This type of intervention has high-reaching effects. The PrEP4Love (P4L) campaign conducted in Chicago has got 6,970,127 views on Facebook and 1,719,446 views on Instagram in three months.
Adherence to medication
Digital platforms, including mobile health apps, play a vital role in improving medication adherence for people living with STIs by sending medication reminders on a regular basis. Various video game-based interventions have been developed to improve medication adherence, particularly among adolescents and young adults.
Digital interventions developed to improve the mental health status of people living with STIs have been found to increase their medication adherence. Such interventions have shown promising outcomes in terms of reducing the perceived stress, anxiety, and depression of HIV patients.
Artificial intelligence for STI management
The application of artificial intelligence (AI) for STI prevention and control has recently been recommended by the US Centers for Disease Control and Prevention. AI-driven methods can analyze publicly available social media data on people’s sexual behaviors related to STIs to predict country-level prevalence of STIs.
By analyzing huge amounts of data within a few seconds, AI-driven tools can easily identify STI-related misinformation available on social media platforms and flag these issues to concerned authorities.
Several studies are already utilizing AI-based tools to analyze electronic health records of people with HIV infection, which helps identify patients who can benefit the most from PrEP.
Furthermore, AI can be used in various virtual reality applications to understand the experiences and stigma of virtual reality users who are living with STIs. This would help create engaging and empathy-building programs to provide STI education, prevention, and treatment resources.
A delay in STI reporting and the accuracy of reported data are the major problems that limit the optimal surveillance of STIs. AI-based tools can analyze the patterns in electronic health record data and insurance claims data to address case-based reporting delays, which in turn can facilitate STI surveillance.
AI-based tools developed by humans are likely to have racial bias. This issue should be carefully addressed. Providing AI tools with a huge amount of public data from diverse backgrounds can reduce biases and improve the accuracy of data analysis. Moreover, ethical aspects of AI-based STI interventions should be carefully addressed by stakeholders engaged in the design, implementation, and monitoring of AI tools.
References
Further Reading
Fear of stigma and rejection can lead to non-disclosure of STI status