Online interventions for sexually transmitted infection/HIV prevention-what next?

摘要

The article by Plant et al1 in this issue of Sexually Transmitted Diseases adds further evidence to the recent literature,2-3 suggesting limited effectiveness of inSPOT, an online program that assists persons diagnosed with a sexually transmitted infection (STI) to notify their partners.4 The outcomes of these evaluation studies are disappointing and also somewhat perplexing. Given the enormous reach of the Internet and the relative ease and low cost with which online interventions can be implemented, would not one expect a more favorable outcome? Indeed, it was as a result of such favorable expectations that many health departments in the United States and abroad had signed up for the program long before studies had demonstrated or refuted its efficacy. And, inSPOT is not the only online intervention facing difficulties, reaching the appropriate populations and achieve sufficient scale to be effective prevention interventions.5 However, before abandoning these programs altogether, it is worth exploring why online interventions for HIV/STI prevention are so difficult to implement and what may be done to improve this.