Social Disease Networking Lets People Own Up Anonymously

In an era when people routinely deliver life-changing news via text and e-mail -- "I want a divorce," "I'm pregnant," "You're fired" -- it is perhaps inevitable that a service offering to automate and anonymize a personal, painful message is gaining traction.

inSpot, a peer-to-peer, Web-based system developed by the nonprofit Internet Sexuality Information Services and the San Francisco Department of Public Health, allows people to send free e-cards to sexual partners informing them that they have been exposed to a sexually transmitted disease. The site allows people to send the cards -- up to six at one time -- anonymously if they choose.

In keeping with Web 2.0 tradition, the cards are eminently customizable, with senders able to choose from various diseases as well as provide links to more detailed information about them.

The site was launched to encourage people who were hesitant to inform casual partners that they might have been infected, Deb Levine, executive director of ISIS, told TechNewsWorld.

Typically, a person who receives a diagnosis of an STD is encouraged by a public health organization to contact their partners.

"They are given the choice of accepting guidance from that organization in informing the partners, or letting the organization do it itself on behalf of the person, or letting the person notify partners on his own," Levine said.

The last option, not surprisingly, is the least effective. "Somehow that job always seems to fall to the bottom of the to-do list," she said.

Fright Risk

The system could be abused by practical jokers or disgruntled former partners who want to torment an ex, Levine acknowledged, but so far that apparently has not become a major concern.

"We have received very few e-mails from recipients who tell us they have been informed in error or as a prank," she said.

Perhaps visitors to the site who have less-than-noble intentions are mollified by the organization's goal of public health safety -- and even benefit from its reminders that sexually active adults outside of monogamous relationships should be tested every three months.

Upwards of 49,500 e-cards have been sent to more than 30,000 people, according to the Web site. The site receives an average of 750 visitors a day. Fewer than 10 recipients have reported receiving an e-card in error.

Since its launch, inSPOT has been replicated in three countries, 10 cities and nine states. Its statistical breakdown provides a revealing look at which STDs are apparently active right now -- at least among Internet-savvy people.

In 2006 and 2007, 23,594 e-cards were sent: 3,631, or 15.4 percent, for gonorrhea; 3,519, or 14.9 percent, for syphilis; 2,203, or 9.3 percent, for HIV; 2,736, or 11.6 percent for chlamydia; and 11,505, or 48.8 percent, for "other," a category that includes cervicitis; "crabs"; scabies; hepatitis A, B and C; lymphogranuloma venereum; molluscum contagiosum; nongonococcal urethritis; shigella; trichomoniasis; and unspecified.

Privacy, for obvious reasons, was paramount when the system was designed, Devine added. "We have no back-end database -- so we are unable to keep information about the senders or recipients of the cards."

Communication Web 2.0-Style

Obviously, face-to-face communication about such intimate matters is the ideal scenario, perhaps seconded by direct communication from a public heath agency. From a psychological perspective, an anonymous e-mail could make what's bound to be difficult news even worse, traumatizing recipients who have no way of questioning the senders.

Still, given the acceptance of online communication, especially among younger adults, an e-mail is preferable to withholding the news all together, said Tom Horvath, a board certified clinical psychologist and founder of Practical Recovery Services.

"I guess I see it as a big experiment, communicating something like this by e-mail," he told TechNewsWorld.

"It is going to be more traumatic for some people to get the news this way -- but then there are always victims of new technology when it is introduced," he noted. "That does not necessarily mean that the technology should not be introduced at all."