Hidden gems in Sexual Health: the use of technology to improve the control of HIV and other sexually transmitted infections
This Editorial highlights recent publications included in a new Collection for Sexual Health on using technology to optimise sexual health. By leveraging innovations such as rapid diagnostic tools, mobile health (mHealth), self-testing and artificial-intelligence-powered tools, we can empower individuals to take control of their sexual health, reducing risks and enhancing accessibility.
Sydney Sexual Health Centre, the largest public sexual health clinic in New South Wales, created an online triage tool to ensure access for consumers from priority populations and refer those from non-priority populations to a more appropriate service. A 2017 review of this triage tool found that it had achieved its purpose in triaging out non-priority populations. It saved a significant amount (approximately 6 months equivalent) of phone triage nurse time previously spent directing patients to other services. More work may need to be done to ensure that the tool is not creating a barrier for priority populations wishing to access our service.
Now available for the first time to young women and people with a cervix (aged 25–29 years), self-collection cervical screening is a safe, accurate and easy method to complete regular cervical screening without the use of a speculum. However, the best ways to communicate and promote self-collection to this age group has not been researched. This is important, because self-collection creates a positive screening experience, and will encourage young people to continue screening throughout their life, ultimately preventing cervical cancer.
Sydney Sexual Health Centre (SSHC) piloted MyCheck, a direct-to-pathology pathway that facilitated bloodborne virus/sexually transmissible infection testing at participating pathology collection centres located across New South Wales. This qualitative study sought to understand perspectives of acceptability of the MyCheck intervention among SSHC clients and providers’. The MyCheck intervention was perceived by both SSHC clients and staff as an acceptable bloodborne virus/sexually transmissible infection testing pathway. However, further work is required to address stigma experienced by some clients when attending pathology collection centres.
Health disparities remain a pressing issue globally, and Chatbot-Assisted Self Assessment (CASA) may enhance sexual health screening intentions among minoritised ethnic groups at risk of sexually transmitted infections (STIs). This innovative study reveals that CASA significantly boosts screening intentions, alleviates concerns about STIs, and fosters positive attitudes towards sexual health screening. Importantly, these findings underscore the potential of artificial intelligence to bridge gaps in health care and contribute to the broader goal of achieving health equity, particularly in underserved communities.
Prior to the global Monkeypox (Mpox) outbreak, we developed a smartphone app (HeHealth) where users can take pictures of their penises with a smartphone to screen for symptomatic sexually transmitted diseases. We further developed the Mpox tool that involved formative research, stakeholder engagement, rapid consolidation of Mpox images, a validation study, and implementation. Artificial intelligence and machine learning approaches can be initiated by smaller datasets and refined along the way, which is important in the event of global pandemics or outbreaks.
Pre-exposure prophylaxis therapy is highly effective in preventing HIV transmission; however, it is markedly underprescribed. Most commonly cited reasons for not prescribing pre-exposure prophylaxis are lack of physician comfort and knowledge. We developed a mobile application (app) that can be used during patient encounters to help clinicians identify appropriate patients and appropriately prescribe therapy. This app can be used in low-resource settings where HIV prevalence is highest.
This paper systematically develops recommendations to improve current and future digital partner notification interventions. It takes findings from the published international literature and then uses tools from behavioural science to generate a series of simple recommendations. The recommendations should be further operationalised locally with key stakeholders for optimal impact.
This study used data sourced from Twitter to characterise social media conversations about syphilis. Accurate medical information was limited, whereas tweets about personal experience generated the most engagement. Coupling medical resources and personal experiences may support public health education on social media.
The success of HIV self-testing requires the user to accurately use the self-test, interpret the result, and be linked to relevant follow-up services. We summarised the systems and tools that have been used to support users through the self-testing process (‘support systems’), and found a diverse range of support systems, including pictorial instructions, in-person support, and virtual tools. We have developed a typology to categorise these support systems, which can be used as a framework for further research.
This major review of the ‘Australian Sexually Transmitted Infection (STI) Management Guidelines For Use In Primary Care’ highlights important aspects of the guidelines and provides the rationale for significant changes.
Repeat chlamydia infection after treatment is common, and testing for reinfection is recommended at 3 months post-treatment, but retesting rates in Australia are low. Sydney Sexual Health Centre introduced an automated, home sampling process for chlamydia reinfection screening in 2019 to help increase retesting rates. This study evaluated home sampling in a real world setting, and found a lower uptake than previously demonstrated in a clinical trial.