Safe sex texts do not stop young people getting STIs, study finds

Researchers examined whether sending the information over text would help reduce the risk of chlamydia or gonorrhoea.

28 September 2022

A text messaging service promoting safe sex does not prevent young people from getting sexually transmitted infections (STI), a new study has found.

Researchers wanted to examine whether texting teens and young adults about safe sex would stop them from getting further infections.

But they found the Safetxt did not reduce reinfection rates.

Indeed the group who received the texts ended up having slightly more STIs than those who were not sent the messages.

Experts from the London School of Hygiene and Tropical Medicine called for the “rigorous evaluation of health communications interventions”.

Their study, published in The BMJ, examined two groups of more than 3,100 16 to 24-year-olds who had a previous infection of chlamydia, gonorrhoea, or “non-specific urethritis” – an infection of the urethra most commonly caused by an STI.

One group did not receive the texts, but had a monthly text checking their postal and email addresses were the same.

The other group were signed up to the Safetxt project which aimed to reduce chlamydia and gonorrhoea reinfection by encouraging participants to follow their STI treatment properly, including
informing partners about their own infection, promoting condom use, and encouraging participants to seek STI testing before unprotected sex with a new partner.

Participants receiving dozens of texts on the subject at varying intervals.

Texts were tailored to gender and sexual orientation and recipients could ask for more information on specific topics.

It was hypothesised that Safetxt would reduce the risk of chlamydia and gonorrhoea reinfection.

But researchers found 22.2% of those who received the Safetxts were reinfected with chlamydia or gonorrhoea.

This compared to 20.3% in the group who did not receive the texts.

But after a year, more participants who received the texts reported using a condom at first sexual encounter with their most recent new partner compared with the group who did not get the texts – 54% compared to 49%.

The study authors wrote: “The Safetxt intervention did not reduce chlamydia and gonorrhoea reinfections at one year in people aged 16-24 years.

“More reinfections occurred in the Safetxt group.

“The results highlight the need for rigorous evaluation of health communication interventions.”

The authors said the World Health Organisation (WHO) recommends the use of digital health communication for “strengthening health systems, including for sexual and reproductive health”, provided that privacy and sensitivity concerns can be taken into consideration.

But the researchers said: “In light of our results, WHO should revise its endorsement of digital behaviour change communication for strengthening health systems, to specify which topics and content WHO endorses.”

They concluded: “Safetxt did not reduce STIs.

“More reinfections occurred in the intervention group. Our results highlight the need for rigorous evaluation of health communication interventions.

“Future work could evaluate the effect of interventions promoting condom use and STI testing in those at risk but with a diagnosis of an STI.

“Further research should focus on how to reduce the stigma associated with STIs to benefit wellbeing, treatment, and precautionary behaviours for those with a diagnosis of an STI, without increasing the risk of infection.”

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