October 7, 2022 – Where do teens and young adults go to talk about sex, sexual health, and sexually transmitted diseases?
It’s likely that routine medical exams and hanging out with friends or partners will become less common than social media platforms for information and advice. And it appears that researchers and clinicians alike are beginning to pay close attention by meeting users wherever they are – both to observe and participate in real-time exchanges on sexual health topics that take place in more equal and stigma-free playing fields.
For patients and clinicians, it is a win-win situation, providing an opportunity to address and prevent the spread of misinformation about STDs, while at the same time helping to reverse skyrocketing rates of some of these infections in 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 colleagues—particularly within a certain age group—are on social media.
“Many have had negative experiences when they disclosed their sexual practices to their doctors, when they felt they were being judged on the number of sexual partners they had, or [felt] She says that having an STD means punishment for bad behavior.
This is especially true for sexual minority youth (LGBTQ), who are clinical Encounters It is often spoiled by clinicians who lack an understanding of gender identity issues, or those who are not comfortable discussing sexual health and STDs with their patients.
Perhaps this explains, at least in part, why platforms like Reddit and its smaller community forums, known as subreddits, are becoming increasingly popular. At last count, there was more from 3.4 million subreddits dedicated to specific topics, including “Ask me anything (AMA)’ STD subreddit (r/STD), which conducts regular online question-and-answer sessions on sexual health and sexually transmitted diseases among a community of 23,000 active users.
Discover and take advantage of r/STD
In 2019, a group of researchers from the University of California, San Diego, conducted a small study to see if people were getting medical diagnoses on social media platforms. They chose STDs as a case study, in part because these infections were more common.
“Our goal was to introduce the concept of crowd-diagnostics, where you go to get a diagnosis on social media for clinical outcomes from your peers,” explains John Ayers, PhD, vice president of innovation in the Division of Infectious Diseases and Global Audiences. Health at the University of California and one of the study authors.
“When we looked at the data, we saw that hundreds of people were going to Reddit and a huge number of them were posting pictures, asking for an STD diagnosis,” he says.
The results of the team were It was published later that year in gamma He highlighted that 58% of the nearly 17,000 posts were requests for crowd diagnosis, 31% of which also included a picture of physical signs of infection. Only 20% of posts requesting a group diagnosis were made to have a second choice after receiving the diagnosis from a physician.
The main idea, Ayers says, is that many clinicians have a “dream field” perspective, “You know, if we build it up, they’ll come. But they won’t come, so why not go and help them where they really are?”
He also explains that it is not enough to simply detect a phenomenon (people using the Internet to get a diagnosis), but by detecting or exposing a problem (potential misinformation), clinicians have a chance to intervene.
That’s exactly what the American Sexual Health Association (ASHA) aimed to explore when I jumped into the r/STD AMA forum armed with two experts—Park and a sexologist—and hosted a discussion on STDs. Their goal was to find out what kinds of information people were looking for, and ultimately to get sexually active people to seek testing through this information. Yes, it means a test Public awareness campaign.
The session resulted in 254 comments, and Park and her co-host addressed 42 questions, the most frequently asked about transmission of sexually transmitted diseases (24%) and testing for STDs (22%). Other FAQs focused on sexual difficulties (15%) and sexuality (15%), although the AMA also included posts discussing contraception, partner communication, research, prevention, and treatment.
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Example: “Can oral herpes be transmitted to your partner like genital herpes during sex. How long should a person wait after an outbreak of oral herpes before having oral sex?” This question received 50 upvotes, indicating approval or support for the post from other participants. Notably, the first response to the question was from a fellow user who recommended that the poster check the Herpes Organization UK website. Park then followed her up with information about how oral herpes spreads between partners during oral sex, the need to wait until the sore has healed before resuming oral sex, and when elimination is most active. |
If results and clicks indicate results, then the ASHA AMA resulted in the best possible results. The session received a 5 out of 5 Reddit AMA points (the benchmark is 4), three community awards, and a CTR back to the ASHA site (and its STD test campaign) at 45% (which 10% exceeded the Reddit benchmark).
Not all that glitters is gold
Reddit AMAs don’t come without risks, and it’s best for those who want STD info to be aware of pitfalls and red flags.
“One thing to think about is that an approach like the subreddit adds to the misconception that STDs in particular have to be symptomatic in order to be a problem, which we know isn’t the case,” explains Dennis Lee, associate professor of psychiatry. and Behavioral Sciences, Health and Well-Being of Sexual and Gender Minorities, at Northwestern Feinberg School of Medicine in Chicago.
“We also have to be careful not to misdiagnose and cause harm,” he says, stressing that many young people – especially those who have equity issues – You have no experience browsing health systems or reputable websites for information.
Ayers agrees.
“One of the results of our study is that people said they had a positive HIV test and were asked to come back and get a confirmatory test,” he explains. “But then someone in the community said don’t worry about it; you’re fine.”
So, “It’s OK to ask for advice but look for confirmation of that advice,” he says. “Be sure to follow [up] with a doctor or go to a forum where you can actually deal with a doctor.”
Despite her participation in the ASHA AMA session, Park has strong words of caution for people seeking advice on social platforms, especially when it comes to Reddit, which carries with it the burden of hosting plenty of trolls.
“Reddit has the highest risk in terms of accepting advice because a lot of times the person replying to you is anonymous. They can say their credentials are x, y, and z, but you have no way of proving that.”
“You don’t know who is answering your question.”
Personally, she says she uses her real name, on the few Reddit forums she’s been to as well as on her own Instagram The page, where STD information is shared.
Park also warns users to avoid someone trying to sell something, as the information is inherently likely to be somewhat biased. Like Ayers, she recommends taking in and verifying information before making health decisions.
Reputable sources include ASHA, the CDC, Scarleteen (a LGBTQ positive, graphic forward site), Planned Parenthood, and of course WebMD.
Health experts call for new preventive strategies
In September, the CDC held STD Prevention Conference 2022which led to the publication of Associated Press news Report who warned of an “STD situation” out of control in the US In addition to the bad news about rising rates of sexually transmitted diseases such as gonorrhea, the CDC also reported that 2021 cases of syphilis have reached a level not seen since 1948 and that Cases of HIV infection have similarly been on the rise.
A key finding from this conference was that prevention is key, especially among high-risk populations such as young people, men who have sex with men, black and Hispanic Americans, Native Americans, and women.
According to Li, the test should be the best result.
“What online resources can really help with is reducing the stigma around testing, making people comfortable asking questions to a medical or health care provider, and helping build trust in the medical system — not just trust that people are doing the right thing, but trust Being cared for in a way that respects you as a person,” he says.
Lee sees sites like Reddit bridging the gap between doing things on their own and knowing when to go to a qualified health professional.
But clinicians may be required to take the leap on social media, even if it’s just to start following users’ accounts and see what people are talking about.
By doing this, “we can reduce the damage,” Ayers says.
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