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Why Texting Public Health Messages Is a Brilliant Idea. Except When It’s Not…

A new service has partnered with a Los Angeles school district – the second largest in the country – to not only deliver STD results by text message, but also to promote the idea children share their “status” as easily as they share the highlight of their day on Facebook. But when it comes to children having sex, it’s never quite that simple now is it?

Qpid.me is the brainchild of Ramin Bastani and operates from the following premise: “We believe that sharing is a good thing and that it can lead to better sexual health decisions, more (safe) sex and fewer STDs.” Bastani went on to tell CNN in an interview: “If it’s cool for a beauty queen to share her STD status [Qpid.me’s celebrity sponsor is Tamie Farrell, Miss California 2009], then maybe kids will start to think it’s cool to share their own results. We want to normalize the idea of sharing your status.”

The process is fairly straightforward. Qpid.me requests patient test results from health clinics (with patient permission, of course) then transmits those results via text, email, and provides access to their online site. The concept of delivering STD results electronically is not necessarily new, or controversial. The danger lies in convincing children there are no concerns about sharing such private information among peers who may not respect their privacy, or, worse may shame them for contracting curable diseases.

Since 2004 sexual health clinics in the United Kingdom have experimented with delivering text messages to patients for both negative and positive test results. The feedback from both patients and clinical staff was noticeably positive. Previously staff would spend up to 120 hours a month contacting patients to deliver mostly negative results that required no follow-up. For those patients who had positive results the delay in contact (prior to the text message-based system) also delayed treatment and increased both the likelihood of complications and that the infection would spread.

Roughly half of the Los Angeles Unified District’s 660,000 students –some as young as age 13 — have been taught in sex education classes how to retrieve their STD status, share it with a partner, and request it prior to engaging in sexual activity. Unfortunately children in Los Angeles County are in a hurry to have a lot of sex, and apparently they’re not making time to use protection either.  CNN notes that in 2011 children between ages 13 and 19 accounted for a quarter of the chlamydia cases and 16% of the gonorrhea cases, according to the Los Angeles County Health Department.

It’s clear there is an epidemic among our youth, and it’s conceivable that delivering STD results via text, e-mail, and mobile apps could stem this tide. But at what cost socially and emotionally? This may promote a false sense of security, leading children to believe a negative STD test taken weeks ago means that a person is still negative. (Though accurate detection depends on a host of variables including the STD testing window).

Thus Qpid.me could create the very problem they are trying to prevent: a rise in unprotected sex. And what if minors trust their partners with test results even when said results are positive?

Can you imagine the rampant embarrassment and “slut shaming” if the information were to leak out (whether purposefully or by accident)? The STD epidemic among children is real, however this solution is definitely not the right one.

John S. Wilson is a health policy analyst focused on long term care and digital health. His work frequently appears in Forbes, CNN, Black Enterprise and the Huffington Post. He is also a Digital Health advisor to the NewMe Accelerator, a start-up tech incubator for minority entrepreneurs. John may be reached on Twitter: @johnwilson.

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Matthew HoltDavid HarlowJohn S. WilsonDoolittlem3 Recent comment authors
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Matthew Holt
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Lucky that pre-Qpid.me there was neither sex nor slut shaming/bullying nor for that matter sharing of information about who was thought to have what STD anywhere in the LAUSD or among any other group of teenagers…. oh, no wait….

John S. Wilson
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John S. Wilson

David, Thanks for the comment. While I agree that the status quo isn’t working and that text messages or other digital communication will resonate with young people and can be used to positively change behavior, I don’t think teenagers are mature enough to avoid sharing sensitive information with this technology in the wrong way. I steadfastly believe more effective conversations with teenagers regarding sex need to happen. I only question the particular method and whether it takes into account the limitations of this younger audience. I don’t think Qpid.me intends to promote sex, however putting this information in the hands… Read more »

David Harlow
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I am an advisor to Qpid.me and I am writing to set the record straight on a few points. Because of the sensitive nature of the information and situations the company deals with, it is important to get this right. The status quo isn’t working. According to the CDC, 20 million people got an STD in the US last year — and half of those infections were among youth. The post gives the impression that Qpid.me is promoting sex to youth. This is just not the case. Qpid.me is promoting testing. Again, per the CDC, only 13% of high school… Read more »

Doolittle
Guest

Oh, and a second somewhat related point People aren’t thinking about this nearly enough as far as I can tell – as completely ludicrous as it sounds – proper mobile device hygiene. How many people do you know who use appropriate measures to disinfect their mobile devices regularly? I’ve seen usage policies, but not many. There are products on the market, but I’m not clear on how well they’re catching on. Let’s do a study that randomly tests a thousand patient and or physician devices and see what we come up with .. I’m willing to bet the results will… Read more »

Doolittle
Guest

Interesting points John. I’ve wondered about this myself – although I hadn’t really given much thought to the sex ed/side of the story. The false security issue is clearly something that needs to be thought about ..

Another thing we need to consider: delivery failure / delay is a big deal. I’m going to stay away from what this means for teens on the verge of getting down to business (“no news is good news”, I’m guessing) – but in other public health scenarios – texts not getting through or coming through late could cause serious headaches

John S. Wilson
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John S. Wilson

Thanks for reading.

Yes, the delivery failure is also something to think about. Although the ability to log in online is probably the catch-all there.

m3
Guest
m3

Fair, fair points. 1-Is a service like this really promoting a culture of trust? 2-Are we back to square one with the delayed notifications? And while similar sentiments have been expressed by those at the National Abstinence Education, let’s be real: they are probably more annoyed that a service like Qpid.me promotes promiscuity. It’s sort of unrealistic to think that one text messaging system can solve all. Why not make the sharing a gradual thing, especially when partnering with such a large school district? What about support groups first, maybe broken down by gender? A wonderful program for adolescents, unfortunately… Read more »

John S. Wilson
Guest
John S. Wilson

Thanks for reading.

Right, I noticed that as well. There’s nothing wrong with having a particular agenda but most consumers aren’t going to view it through that lens. Instead, it’ll be more about consumers’ actual concerns, not the organization’s.

I also agree that the district should look to other types of sexual health promotion before diving fully into this. Although, to be honest, I’m not sure what alternatives they’ve looked into or implemented.

I’ll check that article out.