October 7, 2022 – Where do adolescents and young adults go to talk about sex, sexual health and sexually transmitted diseases?
The obvious – routine medical checkups, outings with friends or partners – are perhaps becoming less common than social media platforms for information and advice. And it looks like researchers and doctors are starting to pay close attention to meeting users where they are – both to observe and participate in real-time conversations around sexual health topics happening in more level and stigma-free games.
For patients and doctors, this is a win-win situation, which offers a chance to address and prevent the spread of misinformation about STDs and, at the same time, help reverse the outbreak of infections. rates of some of these infections among young people.
Ina Park, MD, an STD physician and professor of family and community medicine at the University of California, San Francisco School of Medicine, says nearly all of her patients and those of her colleagues — especially in a certain range of age – are on social networks. media.
“Many had negative experiences when they disclosed their sexual practices to their clinicians, when they felt judged for the number of sexual partners they had, or [felt] that getting an STD meant being punished for bad behavior,” she says.
This is especially true for sexual minority (LGBTQ) youth, whose met are too often marred by doctors who don’t understand gender identity issues or those who aren’t comfortable discussing sexual health and STDs with their patients.
Perhaps this explains, at least in part, why platforms like Reddit and its small, moderated community forums, known as sub-reddits, are becoming increasingly popular. At last count, there were more more than 3.4 million subreddits dedicated to specific topics, including the ‘Ask me anything (AMA)’ STD subreddit (r/STD), which hosts regular online Q&A sessions on sexual health and STDs among a community of 23,000 active users.
Discover and use r/STD
In 2019, a group of researchers from the University of California, San Diego did a small study to find out if people received medical diagnoses on social media platforms. They chose STDs as a case study, in part because these infections were becoming more common.
“Our goal was to introduce the concept of crowd diagnostics, where you go to social media to get a diagnosis for a clinical outcome from your peers,” says John Ayers, PhD, vice chief of innovation at the Division of Infectious Diseases and Global Public Health. Health at UCSD and one of the study authors.
“When we looked at the data, we saw that hundreds of people were going to Reddit and a large majority were posting photos and asking for a diagnosis of sexually transmitted diseases,” he says.
The team’s findings were published later that year in JAMA and pointed out that 58% of the roughly 17,000 posts were crowd diagnostic requests, 31% of which also included a picture of physical signs of infection. Only 20% of posts asking for a mob diagnosis were made to get a second option after receiving a diagnosis from a doctor.
Ayers says the main takeaway is that many doctors have a “field of dreams” perspective, “you know, if we build it, they will come. But they don’t come, so why don’t we go help them where they already are?
He also explains that it is not enough to simply discover that a phenomenon exists (people go online to obtain a diagnosis), but that by discovering or revealing a problem (possible misinformation), doctors have a chance to ‘to intervene.
That’s exactly what the American Sexual Health Association (ASHA) aimed to explore when it hopped on an r/STD AMA forum armed with two experts — Park and a sex therapist — and hosted a discussion on STDs. Their goal was to find out what kinds of information people were looking for and ultimately get sexually active people to get tested through its yes means test public awareness campaign.
The session generated 254 comments, and Park and his co-host answered 42 questions, most often about STD transmission (24%) and STD testing (22%). Other common questions were about sexual difficulties (15%) and sexuality (15%), although the AMA also includes articles on contraception, communication with partners, research, prevention and treatment.
“Can oral herpes be passed to your partner as genital herpes during sex. How long should a person wait after an outbreak of oral herpes before performing oral sex?”
This question received 50 upvotes, indicating approval or support for the post by other participants.
Notably, the first answer to the question came from another user who recommended the poster check out a herpes organization site in the UK.
Park then followed up with information on how oral herpes spreads between partners during oral sex, the need to wait for the sore to heal before resuming oral sex, and when to shedding. is the most active.
If the scores and clicks indicate results, then the ASHA AMA delivered the best possible results. The session received a Reddit AMA score of 5 out of 5 (the benchmark is 4), three community awards, and a click-through rate to the ASHA site (and its STD test campaign) of 45% (which topped 10% Reddit reference).
All that glitters is not gold
Reddit AMAs are not without risk, and those who want information on STDs are best advised to be aware of the pitfalls and red flags.
“One of the things to think about is that an approach like the subreddit adds to the false narrative that STDs in particular have to be symptomatic to be problematic, which we know isn’t the case,” says Professor Dennis Li. psychiatric assistant. and behavioral sciences, and sexual and gender minority health and well-being, at the Northwestern Feinberg School of Medicine in Chicago.
“We also have to be careful not to misdiagnose and cause harm,” he says, pointing out that many young people – especially those with equity issues – do not have experience navigating health systems or reputable websites for information.
“One of the results of our study was that people reported having had a positive HIV test and were asked to come back and take a confirmatory test,” he explains. “But then someone in the community said don’t worry; you’re doing well.”
So, “there is nothing wrong with asking for advice, but seek confirmation of that advice,” he says. “Be sure to follow [up] with a doctor or go to a forum where you can actually chat with a doctor.
Although she participated in the ASHA AMA session, Park has strong caveats for people seeking advice on social platforms, especially when it comes to Reddit, which carries with it the baggage of hosting a lot of trolls. .
“Reddit has the highest risk in terms of accepting advice because often the person responding to you is anonymous. They may say their credentials are x, y, and z, but you really have no way to prove it,” Park said.
“You don’t know who is answering your question.”
Personally, she says she uses her real name, on the few Reddit forums she has participated in as well as on her instagram page, where she shares information about STDs.
Park also warns users to avoid anyone trying to sell something, as the information is inherently susceptible to bias. Like Ayers, she recommends taking the information and verifying it before making health decisions.
Reputable sources include ASHA, the CDC, Scarleteen (a positive and graphic LGBTQ site), Planned Parenthood, and, of course, WebMD.
Health experts call for new prevention strategies
In September, the CDC organized the STD Prevention Conference 2022resulting in a story from the Associated Press report which warned of an out-of-control “STD situation” in the United States In addition to dire news about rising infection rates for STDs such as gonorrhea, the CDC also reported that syphilis cases in 2021 had reached a level not seen since 1948 and that HIV cases were also on the rise.
The main conclusion of this conference was that prevention is essential, especially among at-risk populations such as youth, men who have sex with men, Black and Hispanic Americans, Native Americans, and women.
According to Li, the tests should be the best result.
“What online resources can really help with is reducing the stigma around testing, making people feel comfortable asking questions of a doctor or healthcare provider, and helping to build trust in the medical system – not just by trusting that people are doing the right thing, but by trusting. that you will be taken care of in a way that respects you as a person,” he says.
Li sees sites like Reddit as a bridge between doing things for yourself and knowing when to see a qualified medical professional.
But it may be necessary for doctors to jump on social media, if only to start following user accounts and learning what people are talking about.
By doing so, “we can minimize the damage,” Ayers says.