Generative AI Chatbots as Digital Adjuncts for Sexual Health Information After Prostate Cancer in Men Who Have Sex with Men: An Auto-Netnographic Study
ABSTRACT
Background:
Patient education has moved from brochures to websites, apps, and social media, but the accuracy of digital content is uneven. Telehealth and the rapid uptake of generative AI now embed chatbots in care pathways, offering on-demand guidance yet risking bias, errors, and fabricated citations. Sexual health—especially for men who have sex with men (MSM) after prostate-cancer treatment—remains underserved, prompting patients to seek anonymous online advice. GenAI chatbots could fill this gap, but their contributions must be evaluated through caritative caring theory, technogenesis, and actor-network theory to understand how human–technology networks co-produce caring encounters.
Objective:
This study aimed to describe and compare how four generative AI (GenAI) chatbots respond to questions about sexual health following prostate cancer treatment, focusing on the needs of a gay man, and to theorize these responses using netnographic and actor-network theory perspectives.
Methods:
The first author engaged with ChatGPT (GPT-4o), Claude (3.5 Sonnet), Copilot (GPT-4 Turbo), and Gemini (2.0 Flash) using a standardized prompt. Responses were recorded and analyzed thematically, with attention to performativity, empathy, and cultural sensitivity.
Results:
All chatbots provided accurate, inclusive, and empathetic responses. Themes included clinical content quality, encouragement of dialogue, personalized self-care advice, discussion of same-sex practices, and varying degrees of cultural sensitivity. No hallucinated content was found. Chatbot behaviors were mapped along two continua—logical to empathetic and general to specific—resulting in four interaction types: structured overview, rational clarity, compassionate perspective, and compassionate precision.
Conclusions:
GenAI chatbots can support culturally sensitive, LGBTQI+-inclusive health communication. While they lack ethical consciousness, their performative responses resemble caring encounters and may complement nursing practice in sexual health.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.