Sexually Transmitted Diseases (STDs) have become such a major public health problem across the world that over 1 million STDs are acquired every day worldwide. (World Health Organization, 2021) With an estimated 376 million new infections of curable STDs every year, it is shocking that we are unable to regulate them.
What’s more, STDs can lead to major health consequences, including infertility, an increased risk of HIV, cancers, pregnancy complications, and neurological and cardiovascular problems. Is it because there are no doctors or care available for individuals suffering from STDs?
Not really! Yet, evidence suggests that a majority of these people, especially men, do not approach certified medical professionals for diagnosis and/or treatment despite the presence of these services (Cuffe et al., 2016; Thompson et al., 2016). Why, you ask? Read ahead! But where are these individuals getting the help they need?
Surprisingly, Reddit appears to offer some respite.
People are turning to Reddit for STD diagnosis!
A remarkable number of people are using Reddit to crowdsource information, questions, and/or diagnosis for STDs through one of the popular subreddits - r/STD which has almost 20,000 members.
A research study by Nobles et al. (2019) on Reddit offers fascinating insights. The study’s researchers investigated a sample of 500 posts on r/STD to deconstruct the patterns characterizing users’ inquiries. They discovered that while 58% requested a diagnosis for their symptoms from fellow Redditors, 20% asked for a second opinion following an STD diagnosis by a healthcare provider. The study also revealed that 31% included a photo of their condition's physical signs. This is aligned with HeHealth’s observations and research.
We also observed some common patterns for which these subreddit users tend to:
reveal overtime progression in their symptoms to request diagnoses;
post the lab results/home STD-testing kit results that they are unable to understand;
seek reinforcement of their doctor’s diagnosis;
request advice on how to approach these topics with their partners.
While 87% of posts receive a reply mostly within a day, we noticed that the diagnoses are overwhelmingly inaccurate.
Why are people using Reddit to get information about STDs instead of seeking it from expert doctors?
Through our observations and research, we realized there are a few driving forces behind such behaviors:
Stigma: the most critical factor affecting the willingness to access in-person care is the stigma surrounding STDs (Lichtenstein, 2003). “Stigma can actually impact access to STDs, care, testing, treatment, and this has a very major impact on the quality of life for people.” said Dr. Rayner, sociobehavioral scientist and HeHealth’s Behavior Lead. Concerns about confidentiality, rooted in fear of being stigmatized compel many men to refrain from seeking care (Cuffe et al., 2016). Unfortunately, this stigma is not just a misguided perception but is also the reality that men experience in many healthcare settings providing STD care (Leichliter et al., 2011). Culture and lack of comprehensive sex/sexuality education are some factors that cause this pervasive stigma.
Information and awareness gaps: Another huge barrier is the lack of awareness on STDs and what to do next, especially for those who contract an STD for the first time (or think they did). Stigma and shame surrounding STDs also intensify the hurdles in overcoming this information gap. These uncertainties on who/ where to approach, the time consuming and intimidating nature of making appointments in the current healthcare systems, and questions on their mind such as, “what if it’s not an STD?”, “what doctors even deal with STDs for males?”, “is it even necessary to get tested?”, “what if the doctor will judge me?” lead them to Reddit in hopes of seeking advice/information from an anonymous community that might be able to shed some light or has been in similar shoes as them.
Cost barriers: It is unfortunate that quality STD care is still not affordable to many around the world (World Health Organization, 2019). This inaccessibility pushes many to seek proxy care within a low-barrier environment such as Reddit.
Medical mistrust: Stigma, information and awareness gaps, and cost barriers all affect an individual’s ability to access care. However, some groups are more vulnerable to STDs and their inability to access care due to their medical mistrust. Speaking about this, Dr. Rayner says, “Traditionally these have been the MSM (men who have sex with men) community, racial minorities in certain settings, and those who are socially/ economically disadvantaged.” Due to legacies of racism, homophobia, and structural discrimination that historically prevailed in health settings, many men from such marginalized communities have cultivated a deep distrust for in-person care (Boulware et al., 2003; Armstrong et al., 2007; Powell et al., 2019) that makes community-sourced anonymous proxy care on Reddit all the more appealing.
What is keeping these men on Reddit?
Through our investigation, we have identified these four common factors:
A judgment-free zone and Sense of Community
Ability to get answers
Occasional personalized assistance
These factors, to a certain extent, could help address the aforementioned barriers. However, it's not all rainbows and sunshine.
As we tried to delve deeper into understanding these men's experiences and behavioral patterns, we noticed some crippling drawbacks in using Reddit as a replacement for real care that could culminate in serious health complications:
Most importantly, the amount of medical misinformation, misdiagnosis, wrong treatments/ meds, etc. that prevail on Reddit is frightening!
Judgment from some users— Reddit is not always a safe haven. We have oftentimes noticed other users passing judgment, which could reinforce stigma;
Lack of a mechanism to aggregate wisdom.
What is HeHealth doing to help?
There are several ongoing conversations about bringing doctors to social media platforms to find those in need of medical attention. However, there hasn’t been much progress in the space of STD care.
That’s where HeHealth comes in!
As an initial step towards our mission to help men access the care they need, HeHealth built a subreddit (r/HeHealth) to engage directly with Redditors. Surprisingly, we ended up receiving 5-10 inquiries per day regarding their penis problems within a short period. Medical professionals on our team validate these individuals’ inquiries by offering them sound medical advice in order to prevent medical misinformation.
As we continued to observe these platforms closely, we realized that there are limits to how much Reddit could bridge the gap even if we offer sound medical advice. We started to question, what could we do to truly provide a comprehensive solution that doesn’t just create a safe space for these men but also offers sound information, legitimate medical advice, access to affordable care, and a judgment-free community? How could we go many steps beyond Reddit to truly help these men?
These questions motivated us to create HeHealth’s mobile-centric, AI (artificial intelligence) driven anonymized solution. Our AI-powered STD screening tool can give instant results with just a snap of a photo which allows users to ease their STD anxiety.
HeHealth also works towards building a community with like-minded people, educators, and qualified medical professionals to give our users judgment-free humanistic support and comfort while providing medically accurate information.
Our solution is currently under testing and initial results amaze the healthcare world. Our AI screening tool (STDScreenTM) outperformed GPs (General Practitioners) in certain areas of STD.
We work hard to provide our users with the best possible experience while taking their health into serious consideration. We believe by empowering people with the right information, convenient and private means of care, we are one step closer to helping those who are in need of such care.
Armstrong, K., Ravenell, K. L., McMurphy, S., & Putt, M. (2007). Racial/ethnic differences in physician distrust in the United States. American journal of public health, 97(7), 1283-1289.
Boulware, L. E., Cooper, L. A., Ratner, L. E., LaVeist, T. A., & Powe, N. R. (2003). Race and trust in the health care system. Public health reports.
Cuffe, K. M., Newton-Levinson, A., Gift, T. L., McFarlane, M., & Leichliter, J. S. (2016). Sexually transmitted infection testing among adolescents and young adults in the United States. Journal of Adolescent Health, 58(5), 512-519.
Leichliter, J. S., Paz-Bailey, G., Friedman, A. L., Habel, M. A., Vezi, A., Sello, M., ... & Lewis, D. A. (2011). ‘Clinics aren’t meant for men’: sexual health care access and seeking behaviours among men in Gauteng province, South Africa. SAHARA-J: Journal of Social Aspects of HIV/AIDS, 8(2).
Lichtenstein, B. (2003). Stigma as a barrier to treatment of sexually transmitted infection in the American deep south: issues of race, gender and poverty. Social science & medicine, 57(12), 2435-2445.
Powell, W., Richmond, J., Mohottige, D., Yen, I., Joslyn, A., & Corbie-Smith, G. (2019). Medical mistrust, racism, and delays in preventive health screening among African-American men. Behavioral Medicine, 45(2), 102-117.
Thompson, A. E., Anisimowicz, Y., Miedema, B., Hogg, W., Wodchis, W. P., & Aubrey-Bassler, K. (2016). The influence of gender and other patient characteristics on health care-seeking behaviour: a QUALICOPC study. BMC family practice, 17(1), 1-7.
World Health Organization. (2019). Progress report on HIV, viral hepatitis and sexually transmitted infections 2019: accountability for the global health sector strategies, 2016–2021 (No. WHO/CDS/HIV/19.7). World Health Organization.
World Health Organization. (2021, November 22). “Sexually transmitted infections (STIs): Retrieved from https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)