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Study says texting people about safe sex doesn’t help

The text messages did not did not have the effects researchers anticipated.


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Texting people in the study about safe sex didn't reduce the rate of STIs. (Ground Picture via Shutterstock)

By Danny Halpin via SWNS

Texting young people who have recently had a sexually transmitted infection (STI) about safe sex actually resulted in reinfection rates rising, according to a new study from the UK.

The findings showed that more reinfections occurred in the group receiving texts than in the control group.

Researchers have called for an evaluation of health communication interventions.

Rates of sexually transmitted infections (STIs) such as chlamydia and gonorrhea are highest in people aged 16 to 24.

Texting is a cheap way to deliver health advice and can be effective in some cases, like stopping smoking.

However, despite being recommended by the World Health Organisation (WHO), the new study, published in the BMJ suggests texting doesn’t work for preventing reinfection of STIs.

A review on the effects of sexual health interventions delivered by text message found little high-quality evidence, while the effects on key behaviors such as condom use, partner notification, and outcomes of sexually transmitted infections were uncertain.

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Safe sex text messages were sent to 3,123 randomly assigned participants. (ESB Professional via Shutterstock)

That is why a team of UK researchers set out to measure how effective a series of text messages (safetxt) would be on rates of chlamydia and gonorrhea reinfection in young people after one year.

Their findings are based on over 6,000 people aged 16-24 recruited from 92 sexual health clinics across the UK with a recent diagnosis of, or treatment for, chlamydia, gonorrhea, or non-specific urethritis between April 1, 2016 and November 23, 2018.

A total of 3,123 participants were randomly assigned to the safetxt intervention and received a series of text messages to improve sex behaviors: four texts daily for days 1-3, one or two daily for days 4-28, two or three weekly in the second month and 2-5 monthly for months 3-12.

A further 3,125 control participants received a monthly text message for one year asking for any change to postal or email address.

The researchers expected that safetxt would reduce the risk of chlamydia and gonorrhea reinfection after one year by improving three key safer sex behaviors: partner notification at one month, condom use, and sexually transmitted infection testing before unprotected sex with a new partner.

Data were available for 4,675 (75 percent) participants and characteristics such as age, ethnicity, education and sexual orientation were similar between the groups at the start of the trial.

After one year, the rate of chlamydia or gonorrhea reinfection was 22 percent (693 out of 3,123) in the safetxt group versus 20 percent (633 out of 3,125) in the control group.

At four weeks, 86 percent of participants in the intervention group versus 84 percent in the control group had notified the last partner they had sex with before testing positive to get treatment.

Also at four weeks, 42 percent of participants in the intervention group versus 40 percent in the control group reported using a condom at last sexual encounter, and this difference remained at 12 months (34 percent intervention versus 31 percent control).

At one year, 54 percent of participants in the intervention group versus 49 percent in the control group reported using a condom during the first sexual encounter with their most recent new partner, but the number of STIs was not reduced.

The proportion of people with a new partner and with two or more partners at one year was also higher in the intervention group.

There were several limitations acknowledged by the researchers, including the fact that men were underrepresented in the trial and that many of the secondary outcomes relied on personal reports that could be influenced by participants overreporting desirable behavior or underreporting undesirable behavior.

However, they said that further analyses revealed similar findings and believe their results are sufficiently robust.

They wrote: “Our text message intervention was grounded in psychological theory, incorporating the best evidence on health behavior change, but it did not have the effects we anticipated."

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

They added that further research should focus on how to reduce the stigma associated with STIs to benefit wellbeing, treatment, and precautionary behaviors.

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