Currently submitted to: Journal of Medical Internet Research
Date Submitted: Apr 9, 2026
Open Peer Review Period: Apr 9, 2026 - Jun 4, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Functional Trust in an Untrusted Information Environment: How Chinese College Students Navigate the Digital Sexual Health Knowledge Landscape
ABSTRACT
Background:
Digital platforms are primary sources of sexual health information for young adults, yet they are widely perceived as unreliable. This tension between distrust and reliance remains undertheorized.
Objective:
To examine how Chinese college students use online sources for sexual health information under conditions of uncertainty, and to explore how they navigate the tension between distrust and reliance.
Methods:
We conducted in-depth semi-structured interviews with 22 Chinese college students and analysed the data using a thematic approach informed by an interpretive qualitative framework.
Results:
Participants reported frequent reliance on online sexual health information despite widespread concerns about its reliability. We identify a gap between informational relevance and practical usability, in which information often matches users’ queries but fails to support actionable decisions. To navigate this gap, participants construct what we term functional trust—the capacity to use information with sufficient confidence to act, even without certainty about its accuracy. This process is achieved through adaptive strategies, including cross-platform verification, experiential validation, and platform-specific evaluation. However, constructing functional trust incurs significant cognitive and emotional costs, including confusion, information overload, and search abandonment. Continued reliance on uncertain information is further shaped by structural conditions, particularly the absence of accessible offline sources and the use of precautionary decision-making under perceived risk.
Conclusions:
The use of online sexual health information does not depend on trust in the conventional sense, but on the construction of functional trust under conditions of persistent uncertainty. Addressing challenges in digital sexual health communication requires not only improving information quality but also enhancing its usability and reducing the cognitive burden of navigation within structurally constrained environments.
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