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Ask Dr Google: what STI do I have?
  1. Pin Ming Lee1,
  2. Rosalind Foster2,3,
  3. Anna McNulty1,2,
  4. Ruthy McIver2,
  5. Prital Patel3
  1. 1School of Public Health and Community Medicine, UNSW Australia, Sydney, New South Wales, Australia
  2. 2Sydney Sexual Health Centre, Sydney, New South Wales, Australia
  3. 3The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia
  1. Correspondence to Dr Rosalind Foster, Sydney Sexual Health Centre, Sydney, New South Wales, Australia; rosalind.foster{at}health.nsw.gov.au

Abstract

Objectives Between 2013 and 2014, a third of Australian adults reported using the internet to investigate medical symptoms before consulting a medical practitioner. However, there is limited evidence regarding internet health information seeking behaviour (HISB) in sexual health. This study aims to determine the frequency, predictors and accuracy of internet HISB for sexual health self-diagnosis.

Methods A cross-sectional paper-based survey, available in English, Chinese and Thai, was conducted during April to August 2019 at the Sydney Sexual Health Centre (SSHC). Symptomatic patients were recruited to answer an 18-item survey on their HISB, self-assessed diagnosis, anxiety and health literacy. Survey responses were correlated with SSHC electronic medical record data including participant demographics and clinician diagnosis. Data analyses were performed using Stata V.14.

Results The majority of participants searched the internet (355; 79.1%) before attending clinic, and of these only 16.9% made a correct self-diagnosis. Multivariate analyses demonstrated that relative to Australian-born participants, people born in Asia were twice as likely to undertake internet HISB (adjusted OR (AOR) 2.41, 95% CI 1.25 to 4.64, p<0.01), and those born in Latin America were more likely to self-diagnose correctly (AOR 3.35, 95% CI 1.20 to 9.37, p<0.01). On average, participants who searched the internet scored higher relative to those who did not search, on measures of feeling generally tense (2.26, 95% CI 2.16 to 2.7 and 1.86, 95% CI 1.67 to 2.05, p<0.001), upset (1.96, 95% CI 1.85 to 2.08 and 1.53, 95% CI 1.35 to 1.72, p<0.001) and worried (2.55, 95% CI 2.44 to 2.65, and 2.16, 95% CI 1.95 to 2.38, p=0.001).

Conclusions This study has filled important gaps in the literature and highlighted the high prevalence of adults engaging in HISB for sexual health information. Of concern are the increased levels of anxiety and low accuracy of self-diagnoses associated with HISB. Strategies to direct patients to reputable and user-friendly health websites that mitigate anxiety and misinterpretation of online health information should be explored.

  • diagnosis
  • patients views
  • public health
  • sexual health
  • information technology
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Footnotes

  • Handling editor Jamie Scott Frankis

  • Contributors AM, RF, RM and PP were involved in the conception of the work. All authors were involved in the design of the work; PML, RM, RF and AM performed the acquisition, PP performed the statistical analysis and all authors were involved in the interpretation of data for the work. PML drafted the work and all authors revised it critically for important intellectual content; All authors provided final approval of the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was granted ethics approval on 18 April 2019 by the South Eastern Sydney Local Health District ethics committee (2018/STE00501).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.

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