It’s not all that uncommon to turn to the Internet when you’re looking for answers. Whether it’s hunting down the best local take-out, figuring out why your car is making that weird sound or even a panicked “what side is my appendix on again?” quick-search, the sage wisdom of various blogs, search engines or friendly Internet strangers can offer at least a baseline answer to whatever query you might have.
But just because you can find answers online doesn’t mean you should. There’s never a guarantee that the answers you’ll find are the right ones and, when it comes to your health, that’s a hefty risk to take. Yet, a new study published in the Journal of the American Medical Association (JAMA) found that more and more people are attempting to crowd-source information to try and DIY diagnose sexually transmitted diseases (STDs) and infections. Whether it’s resorting to “Dr. Google” or r/STDs, the behavior is a symptom of a larger problem regarding how we talk about and manage our sexual health.
According to the study, nearly 60 percent of posts on the r/STD subreddit were looking for a crowd-diagnosis, nearly 40 percent of the people asking for help were sharing pictures of their symptoms and 90 percent of those requests got replies. Of course, as you might’ve guessed, the replies often contained inaccurate diagnoses and ineffective folk remedies, as the authors of the study told CNN, which often lead to people going longer without getting an accurate diagnosis or an effective treatment for their conditions.
Stigma Strikes Again
In an interview with SheKnows, Emily Rymland, Nurx Clinical Development Manager, FNP-C, DNP, noted that this phenomenon has a lot to do with larger issues of access to sexual wellness education and healthcare. It’s the financial barriers that keep people from being able to make a visit to a doctor, the more insidious cultural stigmas that make it harder to be open about sexual health, the challenges of talking about something deeply intimate with providers (especially in smaller communities that doesn’t necessarily guarantee privacy or a judgement-free zone) and, as Rymland explains, that some medical professionals are just straight-up not comfortable discussing sex in a real and practical way.
“Providers are uncomfortable talking about sex, particularly with women,” she says. “I don’t know what it is, but patients will go and get their pap smears and — unless you’re a certain mold or type of person — it never comes up. When I say ‘have you been screened for STDs?’ they say ‘You’re the first person who’s asking about it!’ We as providers don’t do a good job of de-stigmatizing it. We should be as comfortable talking about it as we would cholesterol.”
So, when you’re uncomfortable as a patient giving information, the healthcare provider is uncomfortable asking for information and the whole deal feels prohibitively expensive for your troubles (depending on your financial situation and whether you live nearby a good, affordable clinic), it’s not a surprise that desperate people have resorted to Dr. Google or r/STDs when trying to get some answers. “With the Internet, people are like ‘now, finally, I don’t have to say that out loud and can just look up my symptoms,’” Rymland says.
But to state the obvious here: The Internet cannot give you a diagnosis — or the necessary care and treatment you might need — the way a full run of STD/STI tests and a real, thorough talk with a healthcare provider can. Full stop.
“I think that whenever you see a doctor or a nurse practitioner, they should be doing tests that are conclusive,” Rymland says. “If the discomfort on providers side, then people feel like they’re starving for information and they’re not getting tested. You need to have a further dialogue and you need to also be able to talk about who was your sexual partner? When did that happen? When did your symptoms start? What sites are being tested —any part of you that comes in contact with another person? Otherwise, it’s not a good exam and it’s not a good medical conversation — and we’re missing 50 percent of the diagnoses.”
A Solution to DIY Diagnosis
At Nurx, Rymland’s team has been working on solutions to these challenges — in addition to their work making birth control more accessible — they’ve also been working to make information and access to STI screenings just as readily available for patients who might otherwise put off treatment.
With their three STI Home Test Kits (usually covered by insurance but with an option to pay out of pocket), they offer patients a discreet and easy way to be tested for the STIs they might be at risk for, the opportunity to talk with members of Nurx’s medical team and, depending on the telemedicine laws in your state, get treatment for themselves (and, in some states, treatment for their partners) in a discreet, safe and totally shame-free way.
Once a patient selects their kit, it is sent in discreet packaging to their home. The sample collection (which can range from urine samples, a blood card or throat, rectal, vaginal swabs) takes about 15 minutes and is then sent back in a prepaid envelope to Nurx and shipped to their partner lab. The lab, which is CAP and CLIA-certified, analyzes the samples and then Nurx’s medical team contacts the patient to talk about their results and discuss appropriate treatment options — whether that’s oral treatment they can prescribe or working with them to get the in-person care they might need (at an accessible location with providers who are just as savvy about STIs as their own team.)
“I think the special part of what we’re doing is the clinical engagement with the providers — that’s where the education comes in and where women learn they’re normal if they like anal sex, or whatever,” Rymland says. “The first step in getting rid of one’s own stigma about one’s own self.”
And, in the end, the more that can be done to normalize getting regularly tested as a sexually active person, the better: “The recommendations for any sexually active person is to just get tested once a year. Many STIs are asymptomatic and it’s just good to get screened and a great way to start a new relationship with someone: Do it together, get a clean bill of health,” Rymland says. “If we can just let people know that all of this is so normal and that you can have the education to enjoy sex, then I think we’re making a huge impact on people. Sex is great and we want people to love it and do it safely.”