Online assessments of STI risk provide users experiencing urogenital symptoms with more individualized and evidence-based health information that can improve their health care-seeking and provide reassurance in the period before they can access care.
Key Findings
Results
Users viewed the iSpySTI online assessment tool as superior to existing sources of sexual health information such as internet search engines.
14 participants who had used the iSpySTI tool were interviewed using a once-off, semistructured research interview format
The tool was described as providing trusted and probabilistic information compared to general internet searches
iSpySTI is a web-based, Bayesian-powered tool that provides a list of 2 to 4 potential causes of symptoms based on inputs of known STI risk factors and symptoms
The tool was trialed by individuals presenting with urogenital symptoms to a specialist sexual health clinic (Melbourne Sexual Health Centre)
Results
Use of the iSpySTI tool provided emotional well-being benefits to users in the period between noticing symptoms and being able to access care.
Participants reported reassurance during the intervening period between symptom onset and clinical care access
The tool appeared to reduce anxiety associated with uncertainty about potential diagnoses
Descriptive, action, and emotion coding were used to analyze participant experiences
Benefits to emotional well-being were identified as a key theme across the 14 participant interviews
Results
Differences in urgency of health care seeking and emotional impacts varied based on clinical diagnosis type.
Differences were found among participants with non-STI diagnoses, curable STIs, and incurable but treatable STIs
Clinical diagnosis category influenced both perceived urgency of care-seeking and the emotional response to tool use
Comparative analysis of individual cases was used to identify these differences
The study used descriptive, action, and emotion coding to inform the comparative analysis
Results
Country of birth (Australia versus elsewhere) was associated with differences in health care-seeking urgency and emotional impacts of tool use.
Participants born outside Australia showed different patterns in urgency of health care seeking compared to Australian-born participants
Emotional impacts of using the tool also differed based on whether participants were born in Australia or elsewhere
This finding emerged from comparative analysis across the 14 interviewed participants
The finding suggests that cultural background or familiarity with the Australian health care system may influence tool experience
Background
Access to best-practice sexual health care is limited by multiple barriers that online assessment tools may help address.
Identified barriers include cost, distance to care providers, sexual stigma, and trust in health care providers
Delayed diagnosis and treatment of STIs contributes to poorer health outcomes and onward transmission to sexual partners
Online assessments of risk offer a novel means of supporting access to evidence-based sexual health information, testing, and treatment
The tool provides more individualized sexual health information based on user inputs
Methods
The study used a qualitative developmental evaluation design with semistructured interviews and multiple coding frameworks.
14 individuals presenting with urogenital symptoms to a specialist sexual health clinic were recruited
Participants were given the opportunity to trial the tool and then invited to participate in a once-off semistructured research interview
Descriptive, action, and emotion coding informed the comparative analysis of individual cases
The study was described as a 'developmental evaluation' aimed at finding potential users' views and experiences
What This Means
This research looked at what people thought about an online tool called iSpySTI, designed to help people figure out what might be causing their sexual health symptoms before they see a doctor. The tool uses a type of statistical reasoning (Bayesian probability) to suggest 2 to 4 possible causes of a person's symptoms based on information they enter about their risk factors and symptoms. Fourteen people who visited a sexual health clinic and tried the tool were interviewed about their experiences.
Participants generally found the iSpySTI tool more helpful and trustworthy than simply searching the internet for information about their symptoms. Importantly, using the tool seemed to reduce anxiety and provide reassurance during the often stressful waiting period between noticing symptoms and getting to see a healthcare provider. The emotional benefits and sense of urgency about seeking care varied depending on the type of diagnosis a person ultimately received — whether it turned out not to be an STI, a curable STI, or an STI that is treatable but not curable. People born outside of Australia also responded somewhat differently to the tool compared to those born in Australia.
This research suggests that online symptom checker tools tailored to sexual health could play a useful role in helping people navigate uncertainty and access better information, especially when barriers like cost, distance, stigma, or distrust of healthcare providers make it hard to see a doctor quickly. By offering more personalized, evidence-based information, such tools could potentially encourage earlier care-seeking and reduce the emotional burden of waiting for a diagnosis.
King A, Bilardi J, Towns J, Maddaford K, Fairley C, Chow E, et al.. (2024). User Views on Online Sexual Health Symptom Checker Tool: Qualitative Research.. JMIR formative research. https://doi.org/10.2196/54565