JMIR Publications

ABSTRACT

Background:

Delayed diagnosis and treatment of sexually transmitted infections (STIs) contributes to poorer health outcomes and onward transmission to sexual partners. Access to best practice sexual health care may be limited by barriers such as cost, distance to care providers, sexual stigma and trust in healthcare providers. Online assessments of risk offer a novel means of supporting access to evidence-based sexual health information, testing, and treatment by providing more individualized sexual health information based on user inputs.

Objective:

This developmental evaluation sought potential users' views and experiences in relation to an online assessment of risk, including the likely impacts of use.

Methods:

Individuals presenting with urogenital symptoms to a specialist sexual health clinic were given the opportunity to trial a web-based, Bayesian-powered tool that provides a list of two to four potential causes of their symptoms based on inputs of known STI risk factors and symptoms. Those who tried the tool were invited to participate in a once off, semi-structured research interview. Descriptive, action and emotion coding informed the comparative analysis of individual cases.

Results:

Findings support the superiority of the online assessment of STI risk compared to existing sources of sexual health information (e.g., internet search engines) in providing trusted and probabilistic information to users. Additionally, potential users reported benefits to their emotional wellbeing in the intervening period between noticing symptoms and being able to access care. Differences in current and imagined urgency of healthcare seeking and emotional impacts were found based on clinical diagnosis (e.g., non-STI, curable and incurable but treatable STIs) and whether participants were born in Australia or elsewhere.

Conclusions:

Online assessments of risk provide users experiencing urogenital symptoms with more individualized and evidence-based health information that can inform their healthcare seeking and provide reassurance in the period before they can access care.