Risk calculators for HIV and other sexually transmitted infections (STIs) use responses to sociodemographic (e.g., age, sex, ethnicity, geographic location), health status, or behavioural questions to estimate a person’s risk for developing or acquiring STIs. They can also inform the most appropriate action for users to take.
Identifying features for online risk calculators that appeal to STI clinic clients and STI clinic nurses and physicians is a significant task given that more and more individuals turn to the Internet to find sexual health information and a lot of sexual health services and tools are offered online.
A team from the BC Centre for Disease Control (BCCDC), Digital Sexual Health Initiative, set out to understand the content and design features that are desirable to potential end-users of these online tools. They invited clients and healthcare providers from the BCCDC STI Clinic to participate in focus groups. Clinic clients and healthcare providers interacted with and discussed six HIV/STI online risk calculators with different content, design features, question characteristics, target audiences, completion lengths and recommendation messages.
From five discussion sessions with a total of twelve STI clinic clients and five healthcare providers, we identified six main desirable features for online sexual health tools of this kind:
- Provide personalized risk assessments: End-users want risk assessments that reflect their individual sexual behaviours and HIV/STI-related concerns.
- Customize nuanced risk assessment and incorporate tailored educational information: End-users want sophisticated assessments that go beyond merely providing generic messages and recommendations.
- Supply numeric risk estimates: For some end-users, especially those with advanced sexual health knowledge, measurable or numeric estimates are an essential element in making sense of risk information.
- Use non-stigmatizing framing and inclusive design: The language employed in the tools must avoid equating sex with risk or judging users for being sexually active. The design has to be inclusive of different genders, sexual behaviours, racial and ethnic identifications and languages.
- Include explanations and actionable next steps: End-users must understand the questions asked and results provided. End-users must also receive information on concrete actions they could take next to address HIV/STI prevention and testing.
- Develop effective and appropriate branding: End-users want adaptable and reliable tool interfaces, recognized institutional backing of the tool and transparency about the privacy of the information provided in the calculation.
Implications for practice
These findings highlight the importance of incorporating user-oriented feedback in the design of online sexual health tools. Failing to consider users’ preferences in these tools’ designs may negatively impact their acceptability among end-users.
These work also underscores the complexities of incorporating characteristics that appeal to different end-users in an online environment. When well-designed and endorsed by reputable institutions, online tools can complement traditional sexual health services and help fulfil a public health prevention goal.
These findings also draw attention to other sexual health education scenarios. The six identified desirable features might reflect how end-users want sexual health messages communicated to them and what information is of value to them.
For more information
If you want to find out more about this project, check out Digital Sexual Health Initiative’s website: https://dishiresearch.ca/resource/mini-dial-a-nurses-and-good-brands-what-are-the-desirable-features-of-online-hiv-sti-risk-calculators/