E-Cards Warn Of Possible STD Exposure

There is a new category of e-mail that users won't want in their in-boxes, but it could help solve a public health issue.

Since the 1930s, health care workers have used notification to prevent the spread of sexually transmitted diseases. Notification can also mean early diagnosis, treatment, and improved odds for partners exposed to STDs, especially life-threatening infections like HIV and syphilis.

People diagnosed with STDs are often embarrassed to notify previous sexual partners, and many health departments in the United States cannot notify all partners suspected of exposure to all STDs. An online service called inSPOT attempts to solve that problem by allowing Web site visitors to send electronic postcards notifying recipients that they may have been exposed to HIV/AIDS, syphilis, herpes, gonorrhea, and a host of other infections.

An article published Tuesday in PLoS Medicine indicates that the nonprofit's service is making a difference.

InSPOT launched in San Francisco in 2004 as the first Web site of its kind. It allows users to choose one of six e-cards, scroll down through a list of diseases, select one, enter up to six recipients' addresses, and decide whether to include their own e-mail address or to send the notice anonymously. When recipients open the card, they're linked to information about the disease and locations for testing. The site does not keep information about senders or recipients.

More than 30,000 people have sent over 49,500 e-cards since inSPOT launched. Although it's possible for people to use the site maliciously, the study claims that fewer than 10 recipients reported that they received notification in error. The study in PLoS states that click-through rates ranged from 20.4% in Los Angeles to 48.2% in Idaho, with a national average of 26.8% in 2006 and 28.5% in 2007.

From December 2005 through last February, 29,137 people accessed STD testing information after receiving an e-card from inSPOT. Surveys of the general population and HIV providers in San Francisco indicated awareness and acceptance of the service.

"While inSPOT was never intended to replace traditional partner notification by public health investigators, it has emerged as a complement to those services," the article states.

The authors claim that the Web service could become a national and international resource. They hope to collect data on the number of people who get tested after receiving e-cards, as well as the impact the online service has on disease transmission.