JMIR Publications

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 semi-structured in-depth interviews with 22 Chinese undergraduate students (aged 18–25) recruited from eight universities across China using a purposive sampling strategy with maximum variation, complemented by snowball sampling. Interviews were conducted in January 2026. Telephone interviews explored participants' experiences with online sexual health information seeking, including their perceptions of reliability, encounters with contradictory content, credibility evaluation strategies, management of uncertainty, the tension between distrust and continued reliance, and the role of cultural factors in shaping information-seeking behaviours. Data were analysed using reflexive thematic analysis.

Results:

Participants reported frequent reliance on online sexual health information despite widespread concerns about its reliability. Four interconnected themes were identified: (1) a fragmented and unreliable information landscape characterized by abundant but superficial, contradictory, and difficult-to-apply content; (2) incomplete trust yet continued reliance, driven by precautionary risk logic and limited offline alternatives; (3) strategies for constructing confidence through cross-platform verification, experiential validation, and platform-specific evaluation; and (4) hidden costs of navigation, including confusion, information overload, and search abandonment.

Conclusions:

Based on these findings, we propose functional trust as an interpretive conceptualisation describing how users act on information with sufficient confidence despite persistent uncertainty—as an interpretive lens for understanding how users navigate digital health information. Our findings suggest that the use of online sexual health information does not depend on trust in the conventional sense, but may involve 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. Clinical Trial: Not applicable.