STD Quarterly
Use the Internet to stem the spread of STD
On-line syphillis testing service offered
Facing an upward spike in its number of syphilis cases, the San Francisco Department of Public Health has spun its detection web in new directions, using a broad range of innovative Internet-based prevention interventions to stem the spread of the sexually transmitted disease (STD).
The agency is working with San Francisco-based Internet Sexuality Information Services (ISIS), a community-based organization that creates tools to deliver sexual health information, to develop a wide range of prevention interventions to reach those at risk. Its confidential on-line syphilis testing service, STDTest.org, allows people to print out a laboratory requisition slip, have their blood drawn, and receive their test results on-line. This service provides a convenient alternative to getting tested at the San Francisco municipal STD clinic and offers an additional means for detecting syphilis cases.1
Syphilis cases in San Francisco rose from 41 in 1998 to 553 in 2004, says Jeffrey Klausner, MD, MPH, director of the health department’s STD Prevention Section. The San Francisco agency began to look at the Internet as a possible prevention venue after reports indicated that the STD’s spike was associated with men meeting new sex partners through Internet chat rooms and at web sites that facilitate partner meeting.2
The STDTest.org site is just one example of Internet-based intervention, says Deb Levine, executive director of ISIS.3 Its approach to testing offers convenience, accessibility, and an alternative for people at risk who might otherwise not get tested, she states.
During the site’s first year of operation in 2003, a total of 218 tests were performed. Thirteen subjects had positive screening tests, and six new syphilis infections were diagnosed and treated.
Klausner estimates about $20,000 was used to implement the program, with costs covering content development and programming. Since the web site is hosted on a city server, there are no additional costs for hosting the site, he notes. Ongoing costs include the costs of blood draw, testing, follow-up, and treatment.
Get out the word
San Francisco public health officials are looking again to the Internet to boost partner notification with the InSPOT (www.inspot.org) web site. The partner notification web site is aimed at men who have sex with men (MSM), using peer-to-peer e-mail postcards or "e-cards" to alert partners of the need for testing.
At the InSPOT site, MSM who have been diagnosed with an STD can choose from several e-cards to let their partners know they may have been exposed and suggest they get tested. Links to both web sites are listed on the San Francisco City Clinic web site, wwww.sfcityclinic.org.
Cards can be sent anonymously
The InSPOT web site allows users the option of sending cards anonymously or to multiple people at the same time. It helps to reduce the stigma associated with treatable STDs by providing a quick, easy, and light-hearted way to talk about them, says Levine.
"Given the recent increases in STDs in gay men and the value of partner notification in breaking the cycle of continued transmission, we were looking for another way to help gay men approach the subject of STDs that protects an individual’s privacy and empowers men to take the responsibility of informing partners themselves ," says Klausner. "We know that increasing the options for partner notification can effectively reduce the transmission of STDs including HIV infection by encouraging individuals to get tested, diagnosed, and treated."
References
- Levine DK, Scott KC, Klausner JD. On-line syphilis testing — confidential and convenient. Sex Trans Dis 2005; 32:139-141.
- Centers for Disease Control and Prevention (CDC). Internet use and early syphilis infection among men who have sex with men — San Francisco, California, 1999-2003. MMWR 2003; 52:1,229-1,232.
- Klausner JD, Levine DK, Kent CK. Internet-based site-specific interventions for syphilis prevention among gay and bisexual men. AIDS Care 2004; 16:964-970.
Resource
For more information on Internet-based prevention messages, contact:
- Deb Levine, Executive Director, or Tom Kennedy, Director of Communications, Internet Sexuality Information Services, P.O. Box 14287, San Francisco, CA 94114-0287. E-mail: [email protected] or [email protected]. Web: www.ISIS-Inc.orgv.
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