K, Thx 4 The Info: Sexual Health Goes Viral


Texting, instant-messaging and social networking are so popular
among teens that the shorthand has infiltrated American culture — from
lol to cu l8r.

But beyond giving teens their own lingo, lots of health experts are seeing this technology as a massive opportunity to spread information about sexual health resources and facts, and answer questions about the often private conundrums that young people face.

In California, ISIS has launched a text-messaging program called SexInfo,
which enables kids to use a coded text message to get resources. For
instance, teens can text “1″ if their condom breaks, or “2″ to find out
about STDs. And in New York, a group of obstetricians and gynecologists
are testing the effectiveness of text and cellphone reminders as a way
of helping women adhere to their contraception.

Last month, Kaiser Family Foundations and MtvU partnered to launch PosorNot,
a virtual game and online community that helps erase the stigma around
HIV infection. The game also spreads information on testing and
resources for those who have the disease. It’s modeled, cheekily, after
the degrading viral sensation “hot or not” — but that seems to have
gotten the kind of attention a blander site might not garner.

These are just several examples of dozens of hotlines, websites,
cellphone services and more that are springing up to spread sexual
health information around the globe. Using technology to promote health
education is hardly new, but as new media tools gallop across income
groups and geographical areas, so do efforts to capitalize on them,
particularly since the private but interactive nature of technology
suits the issue of sexual health.

“Everyone has questions about their sexual health, reproductive
health, sexuality, relationships. Everyone doesn’t have places to ask
those questions,” says Deb Levine, president of Internet Sexuality
Information Services (ISIS), who has been working to integrate
technology and sexual health for almost two decades. “New media
provides this sense of anonymity, comfort, and privacy, but at the same
time people can really find community and discuss issues.”

Texting For Success

Levine and ISIS conceived of SexInfo when they noticed the ubiquitous presence of cellphones in California teens’ hands. They partnered with the San Francisco Department of Public Health,
and got local organizations that worked with kids to help with the
process, as well as talking to teens themselves. In the first 25 weeks
of this year, 4,500 teens accessed the service, texting in numbers that
stood for particularly popular questions they had about sex, such as
finding out about STDs or info on pregnancy testing.

Since SexInfo’s launch, ISIS has labored to make the interface
simple and compatible with the media teens already love and the most
pressing concerns they have, based on surveys done before the launch.
“The most important thing is that we give them a place to voice
concerns, to interact with them on their terms,” says Levine. “It’s not
just experts answering questions, but experts saying ‘what are your
questions?’”

Isis’ efforts to advertise the program ranged from flyers and bus
shelter ads to getting a popular local hip-hop artist to help spread
the world — but their community partnerships with clergy, juvenile
justice groups, and health educators were particularly vital. They plan
to spread the program, with variations, to DC and Toronto within the
next year, and further after that.

The Buzz on Sticking to Contraception

On the other side of the country, a group of doctors at Columbia
Presbyterian hospital recently conceived of a similar idea. Says Dr.
Paula Castano, an ob/gyn at the hospital: “It was a combination of
myself and other clinicians in our practice noticing when they asked
routine medical questions such as when was your last menstrual period,
patients would pull out their cellphones to check calendars.”

Realizing that patients were latching on quickly to new technology,
Castano and her colleagues saw a chance to use the trend – reminders
via cellphone – to prevent unplanned, unwanted pregnancies. They did an
initial survey in 2005 to decide whether a clinical trial on the topic
was feasible, with promising results. They surveyed women of all ages
in four inner-city family planning clinics, a racially diverse group of
women with incomes largely below the poverty level. They found that 77%
of women under 20 used a cellphone, and almost 90% of those used text
messages. The survey subjects expressed interest in the idea of text
messaging as a way of helping them adhere to contraceptive methods.

Castano and her colleagues are currently working on a clinical trial
to explore the usefulness of text reminders on contraceptive adherence,
which isn’t easy for any woman but can be particularly difficult for
women in distressed circumstances.

“Cell phone use is skyrocketing,” she says. “And even though users have gone up, the monthly bill has stayed the same.”

Challenging Stigma, Virtually

Using pop culture to endorse do-good initiatives is nothing new for
the folks at Mtv U, Mtv’s college station. Their viral “Darfur Is
Dying” game snagged the attention of their longtime partners at Kaiser Family Foundation,
who hoped to do something similar with AIDS-related issues. The folks
at Kaiser realized that their target audience had shifted the media
they consumed, and are “not always watching TV or looking at billboards
or listening to radio.” Rather, says Meredith Mishel, senior program
officer at Kaiser, “they’re gaming.”

Kaiser joined forces with Mtv U and Poz magazine, the magazine
for those living with HIV and AIDS, and sponsored a contest to design a
game that would both combat stigma and spread health information. From
the contests, the seeds for PosorNot, which launched April 31 with
fanfare from pop artists like Will.i.am and Fall Out Boy, were sown.

PosorNot features a group of incredible people — Mishel is full of
grateful praise for their courage and conviction — who have agreed to
create surfable online profiles. Based only on appearance and a few
initial details, participants are asked to guess whether these people
have HIV or not, in the process learning to question their own
assumptions about who is at risk for the disease. After they click
through, users learn more about those who are affected by HIV either
directly or indirectly, and are pointed to information about the
disease and testing.

The relative security of the online interface, combined with the
deeply personal experience of seeing human stories in front of them,
enables a more thorough self-examination process. Younger generations
tend to know there’s something inappropriate about voicing their own
assumptions when it comes to HIV. But without voicing those
assumptions, it’s hard to have them debunked — which makes the beauty
of an online, anonymous game obvious.

But more than just fostering personal discovery, the site provides
constant opportunities to send users towards information on getting
tested. In just one April day, they sent the entire month’s
sixth-highest number of visitors to the CDC’s HIV page.

“People are staying for a while, exactly what we’re hoping they’d do,” says Caroline Herter, a program associate at Kaiser.

Ring It Up

Clearly, the use of technology to spread health info in the US is on
the rise in a major way. But in other countries, where poorer
infrastructure leads to an increased reliance on cellphones — or where
better technology introduced cellphones earlier — the implications are
equally exciting.

The UN Foundation and Vodafone recently released a report
including multiple case studies of groups using cellphones to improve
health conditions around the globe. SexInfo was spotlighted as one such
intervention, but their case studies included NGOs using cellphone
technology in Nigeria, South Africa, Argentina and beyond. In these
countries as well as in the US, the benefits from using technology are
the same: efficiency, anonymity, a chance to explore the wider world,
and interaction with already beloved technology. In the near future,
the buzz of phones or pings of a new e-mail may offer more than a
social hello — they can also provide vital, life-altering health
information around the globe.

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Follow Sarah Seltzer on twitter: @sarahmseltzer