inSPOT: The First Online STD Partner Notification System Using Electronic Postcards

I n the United States there are 19 million new sexually transmitted disease (STD) cases diagnosed each year, including 900,000 reported cases of chlamydia, 330,000 reported cases of gonorrhea [1,2], and 55,400 estimated new HIV infections per year [3]. Notifying sexual partners of their potential exposure to an STD has been a mainstay of disease prevention and control since the 1930s [4]. Recent evidence-based reviews concluded that partner notification is effective for identifying those at risk for STDs [5] and HIV infection [6]. Traditionally, partner notification has been done in person, by phone, or by mail, with the assistance of a public health investigator. The high number of cases of gonorrhea and chlamydia, however, makes partner notification for all named partners impractical in many jurisdictions [7]. Particularly among gay men and other men who have sex with men (G/MSM), who tend to have higher numbers of partners, online notification may be an effective strategy to increase partner notification [8]. Recent survey data suggest that with the ease and privacy of online communication, more patients would be willing to receive notification of possible exposure to disease via e-mail or other new technologies [9]. Other studies have shown that online partner notification is an efficient method for reaching individuals otherwise inaccessible [10,11]. In a sample of 833 G/MSM in San Francisco, California, 73% responded " yes " when asked, " If you were diagnosed with an STD, would you consider sending an anonymous e-card to notify anyone you had sex with? " The primary reason for being unwilling to use an e-card to notify a partner was the respondent's preference to notify his partner/s in person [12]. This article will describe an innovative online e-card service for partner notification, the process of replication of this site across cities, states, and countries, initial evaluation results, and future research needs.(c)3 nonprofit organization, conducted needs assessment and community discussions with G/MSM in San Francisco and determined that most men told their primary partners when they were diagnosed with an STD (either by themselves or with the help of a public health investigator), but despite good intentions, they did not tell their casual sex partners. Men overwhelmingly said that if there were an easy, convenient, and anonymous way to inform their partners of their potential disease exposure, they would use it. ISIS then developed inSPOT (http://www. inSPOT.org/), a peer-to-peer, Web-based, STD partner notification system, in partnership …