Got an STD? Send an inSPOT E-Card To Notify Partners

There is one sentence that you failed to cover in the post above. I appreciate that it was near the end of the PLoS piece so you may well not have read that far. That sentence is:

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

This indicates that, as the health intervention it was designed to be, it has been a roaring success. Now it is easy for people to sit and get on the moral high ground about people having high partner numbers and not disclosing that they have an STD but let’s look at a number of factors that go along with this health intervention…

Firstly the advent of the internet has facilitated a whole new environment for gay men to hook up with each other (as inSPOT was designed for gay men, its fair to look at them). Secondly we have, as a result of the internet, very distinctive modes of casual sex. We have the traditional, in the form of gay men who frequent PSE’s and PSV’s (PSE’s are Public Sex Environments such as parks or other outdoor cruising areas and PSV’s are Public Sex Venues, such as bath-houses and sex clubs) Then we have the gay men who arrange sex dates on the internet. This is a very important distinction because not all men who meet in PSE’s & PSV’s actually exchange phone numbers and, most importantly, email addresses. (Remember you have to have an email address to use inSPOT). So this means that the majority of gay men that would be using inSPOT are probably men who use the internet for sex dates.  

Gay men’s sexual practices on the internet can often be a highly complex affair. There are quite a few dimensions to it. The obvious being what people actually want to do and the role that they will play during sex. We have the men who like having unprotected sex (like many heterosexuals) and we have men who like having protected sex (like many heterosexuals). We have men who like having unprotected sex who engage in what we call “Sero-Sorting” and these are men who have sex with men with the same sero-status as themselves… so a HIV positive man will seek to have sex with other positive men and HIV negative men will seek to have sex with other HIV negative men. The internet enables these men to discuss, in a responsible fashion, their current sexual health status (that they are aware of). It goes without saying that, of course, there are those people who do not engage in this process.

A service such as inSPOT provides gay men the ability to broach the subject of their subsequent discovery of a disease (that they have been diagnosed with) that they were not aware of at the time of sex. If you have met someone ONCE for sex and you are unlikely to meet them again then this allows you to take the RESPONSIBLE action of alerting them to go and get tested EARLY. This is a crucial factor because it is spectacularly well documented that the existence of an undiagnosed STD in a person who is HIV negative can greatly increase the probability of infection occurring after sexual exposure to HIV.

The point that I am making here is that inSPOT can be a valuable tool in both the prevention of lesser STDs, which in turn can greatly reduce the onward transmission of more major, life threatening and resource draining infections, namely HIV and Hep C.

Failure to make optimum use of new communication technologies will do nothing but fuel these epidemics.

I think it is unfortunate that you chose to use this valuable piece of research by PLoS to grind your own axe and make such moralistic, and might I say ill-considered statements.

At the end of the day responsibility is a two way thing. It is perfectly clear that your country has learnt this least of all as Canada has the dubious honour of prosecuting more people per capita for the sexual transmission of HIV than any other country on the planet! And we all know that such prosecutions stigmatise those living with HIV as well as driving people away from testing services.

Regards!