The Pulse

November 25, 2019

Does Diagnosing STIs Over Chat Forums Online Actually Work? It's Best Not To Try

6 minute
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There’s an itch, a tingle, a red oozing bump. It’s somewhere on your genitals. Your mind races to every possible scenario. Could it be an STI?

Statistically speaking, yes, it could. But, it happens to about half of sexual active people by the age of 25, so you’re not alone. Across the globe, over 1 million STIs are acquired every day. So what should you do if something doesn’t feel right and you think it might be the result of an STI? What if you had unprotected sex and aren’t experiencing symptoms, but are worried you contracted an STI?

It was reported in recent research published by The American Medical Association that between 2010 and 2019, almost 17,000 people looked to the internet community on Reddit to get answers. People are posting pics of rashes and sores with graphic descriptions of their symptoms in the hopes of getting a diagnosis from their peers. The answers can come back almost instantly, but are they trustworthy?

Getting an STI diagnosis online

As many medical professionals and sex educators will tell you, crowdsourcing an STI diagnosis is not a great idea. Since STIs are so prevalent, it’s true that many members of an online crowdsourcing community might be STI-positive and know what herpes blisters or genital warts generally look like, but unless they are trained healthcare providers, they likely can’t discern an infection on another person’s genitals. Moreover, it’s risky to not seek a professional diagnosis because untreated STIs can lead to worse infections, infertility and even some forms of cancer — but a licensed doctor can easily treat them before they become more severe.

So what’s up with the increased number of folks seeking an online diagnosis? It’s because of the immense stigma associated with STIs, Jenelle Marie Pierce, Executive Director of The STI Project, says to O.school. “Most folks are hesitant to go to a clinic or their regular provider, for fear they'll be seen by peers, friends, family; some are hoping desperately it's not an STI; and then others don't have the resources to get tested,” she said.  

Of course, there’s also the other barriers that keeps people from accessing STI care: lack of health insurance and inability to afford healthcare or take time off from work.   

Treating an STI at home

It’s common for people seeking STI help online to want a quick fix. (Honestly, who doesn’t?) Some users don’t want their parents to find out they are sexually active, while others don’t have insurance and can’t afford treatment. Many go on Reddit requesting advice for home treatments like turmeric, green tea extract or turkey tail mushroom. 

While at-home remedies like apple cider vinegar or tea tree oil might address genital odor or an ingrown hair, most STIs are caused by bacteria and viruses that require medication and won’t go away on their own. The best plan of action when it comes to treating an STI is to see a healthcare provider who can screen, diagnose and treat it. 

It’s also important to get a diagnosis from a healthcare provider so that you can share the results with any recent sexual partners so they can access treatment, too. 

When to get tested for STIs

If you’re experiencing STI symptoms like itching, swelling or general genital discomfort, it’s best to have a professional check it out. Even if it’s not an STI you’re experiencing, you can get help for your symptoms. 

If you’ve been recently had unprotected sex and want to get screened for STIs, here’s what you should know. 

HIV

  • If you think you were exposed to HIV in the last 72 hours, see a provider ASAP. You might qualify for post-exposure prophylaxis that can prevent infection.
  • Symptoms may appear 2-4 weeks after infection. They include flu-like symptoms. 
  • You can be tested for HIV as soon as 10-90 days after exposure depending on the type of test. 

Chlamydia and Gonorrhea

  • These bacterias can be detected 5-14 days after exposure. 
  • You should get tested and treated ASAP if you know you were exposed. 
  • Chlamydia symptoms can appear in 7-21 days. 
  • Gonorrhea symptoms can show up 1-14 days after exposure. 

Syphilis

  • First symptoms can appear 10-90 days after exposure. 
  • You can be tested for syphilis 3-6 weeks after exposure.

Hepatitis C (HCV)

  • Not everyone develops symptoms, but they can appear in 2-26 weeks. 
  • HCV can be detected 4-10 weeks after exposure. 

Hepatitis B (HBV)

  • Symptoms might not occur, but can how up 60-150 days after exposure. 
  • It can take up to 9 weeks for the virus to be detectable in a blood test. 

Phew. That sounds like a lot of math. Don’t worry, you don’t have to remember all those numbers. If you’ve have unprotected sex, visit your healthcare provider and let them figure it all out for you. 

Yearly screenings for STIs

The U.S. Preventive Services Task Force (USPSTF) recommends different screening intervals for different groups of people:

  • Everyone from ages 13 to 64 should be tested at least once for HIV. Get tested for HIV yearly if you have unprotected sex. 
  • Gonorrhea and chlamydia screening is recommended for all sexually active people with cervixes under the age of 25 (Both viruses can lead to pelvic inflammatory disease in people with uteruses if left untreated). 
  • All pregnant people should be tested for syphilis, HIV, hepatitis B, chlamydia and gonorrhea. 
  • Get tested yearly for chlamydia, gonorrhea, HIV and syphilis if your sexual behavior includes multiple current partners, having a new partner, inconsistent condom use, having sex while drinking or doing drugs and having sex as a sex worker. 
  • People with penises who have sex with other people with penises should get tested every year for HIV, syphilis, chlamydia and gonorrhea. (And you can bump it up to every 3-6 months if you have multiple or anonymous partners.)

If embarrassment is keeping you from visiting a provider, try either an online testing provider or platforms like Lemonaid Health, STD Check, or Fig at Home. It’s true these platforms are online, just like Reddit, but the difference is that they are staffed by medical professionals who use validated tests to determine if you have an STI. 

Safer ways to seek support online 

If talking to other people about your STI symptoms gives you some comfort, feel free to engage with your online community in a way that works for you — but, as a responsible second step, always follow up with a healthcare provider to make sure you don’t need further treatment or prescription medication. If you aren’t able to afford a visit to your regular healthcare provider or can’t afford one from an online provider, call your county health department and ask for a referral. Many counties offer free or low cost STI screening through local clinics.

Dr. Sarah Toler is a Certified Nurse Midwife and Doctor of Nursing Practice. As a teenager, Sarah dreamed of being a sex therapist, but grew up to be a midwife instead because she realized that as a midwife, she could talk a lot about sex and provide people access to contraception. In addition to sexual and reproductive health, she specializes in women’s mental health, particularly postpartum mood disorders. Sarah believes access to evidence-based reproductive health information for all people is a human right.

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