Lessons from COVID-19 for sexually transmitted infections: Listening and learning from young adults and healthcare providers on sexual health communications dynamics and decisions in four states.
Raynor J, Stephens J, et al. • Patient education and counseling • 2025
Lessons from COVID-19 pandemic communications can improve STI messaging by aligning multiple trusted sources, increasing provider accountability for affirming sexual health discussions, and supporting patient-driven communications to address individualized STI information needs.
Key Findings
Results
Half of young adults identified the CDC and the news as primary trusted sources of COVID-19 information, while providers were identified as the primary trusted source for STI information.
Study interviewed 55 young adults and 49 healthcare providers across four states (California, Florida, Louisiana, and Missouri)
Interviews conducted between October 2020 and October 2021
Young adult participants included Black/African American MSM, Latinx MSM, Black/African American transgender women, Latinx transgender women, and Black/African American cisgender women
This divergence in trusted sources between COVID-19 and STI information suggests different communication channels are needed for different health topics
Results
Providers incorrectly perceived that young adults receive sexual health information primarily from the internet, peers, and social media, when in fact young adults trusted providers most for STI information.
This represents a disconnect between provider assumptions and young adult behavior regarding STI information-seeking
Providers included medical doctors, doctors of osteopathy, nurse practitioners, physician assistants, and registered nurses
The misperception by providers may lead to missed opportunities to serve as a primary trusted information source for STI education
The finding underscores the importance of providers actively engaging in STI conversations rather than assuming young adults are self-informing through informal channels
Results
Nearly all young adults assessed their likelihood of contracting both COVID-19 and STIs as low, indicating broadly low perceived risk across both infection types.
Low risk perception was found among demographic groups already experiencing disparate rates of STIs
This low perceived risk applied to COVID-19 despite interviews occurring during the active pandemic period (October 2020–October 2021)
The finding suggests that low risk perception is a shared challenge for both COVID-19 and STI public health messaging
Authors recommend addressing low-risk perception by emphasizing factors both within and outside of young adults' control that can facilitate an ongoing sexually healthy life
Discussion
COVID-19 communication lessons suggest STI messaging should align multiple trusted sources to reduce message variability.
The COVID-19 pandemic response highlighted how consistent messaging across multiple credible sources improves public health communication
STI information was recommended to be presented in a simple, consistent manner from multiple credible sources, particularly providers
Message variability across sources was identified as a barrier to effective STI communication
The multi-source alignment approach mirrors successful elements of COVID-19 public health communications
Discussion
Providers should promote patient-driven conversations about sexual health that are empathetic and non-judgmental.
The study identified increasing provider accountability for affirming sexual health discussions as a key recommendation
Patient-driven communication was recommended to address individualized STI information needs
Communicating with empathy in a non-judgmental fashion was specifically highlighted as important for young adults in the studied demographic groups
This recommendation was derived in part from observing how COVID-19 communications engaged patients and the public
Methods
The study was conducted using qualitative interviews with young adults from demographic groups experiencing disparate STI rates across four geographically and politically diverse U.S. states.
Total sample: 55 young adults and 49 healthcare providers
States included California, Florida, Louisiana, and Missouri, representing geographic and political diversity
Young adult groups were selected specifically because they experience disparate STI rates: Black/African American MSM, Latinx MSM, Black/African American transgender women, Latinx transgender women, and Black/African American cisgender women
The qualitative design allowed exploration of COVID-19 and STI information sources, perceived risk, and messaging dynamics
What This Means
This research suggests that lessons learned from COVID-19 public health communications can be applied to improve how we talk about sexually transmitted infections (STIs) with young people. Researchers interviewed 55 young adults from communities disproportionately affected by STIs and 49 healthcare providers across California, Florida, Louisiana, and Missouri. They found a notable disconnect: while young adults trusted doctors and other healthcare providers most for STI information, providers assumed young people were getting that information from the internet, social media, and peers. This gap may mean providers are missing opportunities to be the influential, trusted voices they actually are for young adults seeking STI information.
The study also found that nearly all young adults rated their personal risk of getting both COVID-19 and STIs as low, even among groups who statistically face higher rates of infection. This widespread underestimation of risk was consistent across both disease types and highlights a shared communication challenge. The research draws parallels between COVID-19 messaging strategies and what could work for STI education, suggesting that consistent messaging from multiple credible sources — especially healthcare providers — can help address this low perceived risk.
This research suggests three practical improvements for STI public health communication: first, aligning messages from multiple trusted sources to reduce confusing contradictions; second, encouraging healthcare providers to lead open, empathetic, and non-judgmental conversations about sexual health rather than waiting for patients to bring it up; and third, reframing STI risk communication to help young people understand both the factors they can control and those they cannot, in order to support long-term sexual health. These findings are particularly relevant for young adults in communities that already face health disparities.
Raynor J, Stephens J, Harris I, Sukhija-Cohen A, Natoli L, Wolfson S. (2025). Lessons from COVID-19 for sexually transmitted infections: Listening and learning from young adults and healthcare providers on sexual health communications dynamics and decisions in four states.. Patient education and counseling. https://doi.org/10.1016/j.pec.2024.108607