Where can teenagers and young adults discuss sexual activity, sexual health, and STDs?
Regular doctor visits and hanging out with friends or partners are obvious options, but social media platforms may be replacing them as a source of knowledge and guidance. And it seems that both scientists and medical professionals are beginning to pay close attention by going where the users are in order to monitor and participate in real-time discussions about sexual health issues that take place on more even, stigma-free playing fields.
It’s a win-win situation for both patients and doctors, one that offers the ability to confront and stop the spread of STD misinformation while also assisting in the reversal of the increasing rates of some of these illnesses in younger individuals.
Almost all of her and her colleagues’ patients, particularly those who fall within a certain age range, are on social media, according to Ina Park, MD, an STD specialist and professor of family and community health at the University of California, San Francisco School of Medicine.
According to her, “many have had awful experiences when they’ve reported their sexual practises to their physicians, when they felt like they were being judged for how many sexual partners they had, or [thought] that contracting an STD meant getting punished for bad behaviour.”
This is especially true for LGBT kids, whose clinical experiences are all too frequently ruined by medical professionals who don’t understand gender identity concerns or who aren’t at ease talking about sexual health and STDs with their patients.
Perhaps this helps to explain, at least in part, the increasing popularity of websites like Reddit and its smaller, regulated community forums, known as subreddits. The ‘Ask Me Anything (AMA)’ STD subreddit (r/STD), which hosts frequent online question-and-answer sessions on sexual health and STDs among a community of 23,000 active members, is one of more than 3.4 million subreddits on Reddit that are devoted to certain themes.
Finding and Utilizing r/STD
In order to determine whether people were receiving medical diagnoses on social media platforms in 2019, a team of researchers from the University of California, San Diego, conducted a short study. They selected STDs as a case study in part due to the fact that these infections were becoming increasingly widespread.
According to John Ayers, PhD, vice chief of innovation in the Division of Infectious Diseases and Global Public Health at UCSD and one of the study’s authors, “our goal was to introduce the concept of crowd diagnosis, where you go to obtain a diagnosis on social media for a clinical outcome from your peers.”
“When we looked at the data, we found that hundreds of people were visiting Reddit, and a sizable percentage of them were submitting photographs and soliciting a diagnosis of sexually transmitted illnesses,” he claims.
Later that year, the team’s research was published in JAMA and showed that 31% of the roughly 17,000 posts had images of physical evidence of infection, making up 58% of the requests for a crowd diagnosis. Only 20% of posts seeking a crowd diagnosis were done so to get a backup diagnosis after getting one from a doctor.
The key lesson learned, according to Ayers, is that many doctors have a “field of dreams” mentality, believing that if we construct it, they will come. Why don’t we go aid them where they are already if they aren’t coming?
Additionally, he notes that identifying a phenomenon—such as people seeking diagnoses online—does not suffice since by identifying a problem—such as potential misinformation—doctors have the opportunity to take appropriate action.
The American Sexual Health Association (ASHA) jumped onto a r/STD AMA forum with two specialists, Park and a sexologist, and organised a conversation about STDs with that precise goal in mind. Through the Yes Means Test public awareness effort, they hoped to find out what kinds of information people were looking for and ultimately persuade sexually active people to seek testing.
The session received 254 comments, and Park and her co-host responded to 42 of them. The most frequently asked concerns concerned STD testing (22%) and transmission (24%). Although the AMA also contained postings addressing contraception, partner communication, research, prevention, and therapy, other frequently asked topics concentrated on sexual issues (15%) and sexuality (15%).
The ASHA AMA produced the best outcomes imaginable if scores and click-throughs are any indication of results. Reddit users gave the session a score of 5 out of 5 (the benchmark is 4), three community awards, and a click-through rate of 45% (which was more than the 10% Reddit criterion) back to the ASHA website and its STD testing campaign.
Not every shiny object is gold.
It is advisable for anyone seeking information on STDs to be aware of the risks and warning signs associated with Reddit AMAs.
Dennis Li, an assistant professor of psychiatry and behavioural sciences, as well as sexual and gender minority health and well-being at Northwestern Feinberg School of Medicine in Chicago, says that one thing to consider is that an approach like the subreddit contributes to the false narrative that STDs in particular have to be symptomatic to be problematic, which we know is not the case.
He emphasises that many young people – especially those with equity concerns – lack expertise accessing health institutions or reliable websites for information, saying, “We also have to be careful not to misdiagnose and perhaps inflict harm.”
People who reported having a positive HIV test and being requested to return for a confirmatory test was one of the outcomes of our study, the author says. But then a member of the neighbourhood reassured him, “Don’t worry about it; you’re fine.”
Therefore, he advises, “it’s OK to seek guidance, but look for confirmation of that advice.” “Be sure to follow up with a doctor or visit a forum where you may interact with a doctor directly.”
Despite taking part in the ASHA AMA session, Park has strong advice for those looking for guidance on social media platforms, particularly when it comes to Reddit, which has a reputation for hosting a lot of trolls.
“Reddit has the biggest risk when it comes to following advise because anonymous responses are common. They may claim to have x, y, and z, but you really have no way of verifying it, says Park.
You have no idea who is responding to your query.
In her own words, she claims to use her own identity in the few Reddit groups in which she has participated as well as on her Instagram page, where she posts information about STDs.
Park also advises consumers to steer clear of anyone trying to sell them something because the information is prone to prejudice by its very nature. She advises taking the knowledge and verifying it before making health decisions, much like Ayers.
ASHA, the CDC, Scarleteen (an LGBTQ-positive, graphic-heavy website), Planned Parenthood, and, of course, WebMD are all reliable sources.
Health Professionals Demand New Prevention Methods
The CDC conducted the 2022 STD Prevention Conference in September, which led to an Associated Press news story warning of an unmanageable “STD scenario” in the United States. Along with the alarming news of increased rates of STD infections, including gonorrhoea, the CDC also announced that in 2021, syphilis incidence hit a high not seen since 1948 and that HIV cases were also climbing.
The main message of the conference was the importance of prevention, particularly for at-risk groups including young people, homosexual males, Black and Hispanic Americans, Native Americans, and women.
The best result, in Li’s opinion, should be testing.
“Online resources can really help with reducing stigma around testing, getting people comfortable asking questions to a doctor or other healthcare professional, and helping to bolster trust in the medical system,” he says. “Not just trust that people are doing the right thing, but trust that you’ll be taken care of in a way that respects you as a person.”
Sites like Reddit, in Li’s opinion, fill the gap between knowing when to seek professional medical advice and doing things on one’s own.
However, doctors might need to join social media, even just to start monitoring user profiles and find out what others are talking about.
According to Ayers, by doing this, “we can reduce the harm.”