A new purpose for dating apps: STI surveillance

Heather Meador and Anna Herber-Downey use dating apps at work, and their supervisor is aware of this.

Both are employed as public health nurses at the Linn County Public Health department in eastern Iowa. They’ve discovered that dating apps are the most effective approach to alert users that persons they’ve met on dating sites may have exposed them to sexually transmitted illnesses.

According to the Centers for Disease Control and Prevention, recorded instances of gonorrhea and syphilis will increase by 10% and 7%, respectively, from 2019 to 2020, and Iowa is not immune. The pair has discovered that telephone calls, a typical means of tracing contacts, are no longer effective.

“When I started 12 years ago, we phoned everyone,” said Meador, clinical branch supervisor of the county health department. It is becoming increasingly difficult to just call someone on the phone.

They argued that even texting is futile. And Facebook users do not necessarily respond to messages. Dating apps are the current trend.

Contact tracers sometimes just have a screen name or a photo to work with because so many individuals meet their sexual partners online via services such as Grindr and Snapchat, which are based in West Hollywood and Santa Monica, California, respectively.

In order to contact the sex partners of sick individuals, Meador and her coworkers received permission from their local supervisors around one year ago to create accounts on the app.

Traditionally, contact tracers interview individuals infected with a sexually transmitted infection (STI) about their previous sexual partners and subsequently notify them of the possible exposure.

Contact tracers in Linn County utilize the applications throughout their workday. Grindr, in particular, relies on geolocation to display people nearby matches. Consequently, the tracers utilize the applications while they are out and about in the hopes of wandering into the same neighborhoods as the individual with a STI. Occasionally, users “touch” the contract tracers to check if they are interested in dating.

When public health authorities locate the individual they are searching for, they send a message requesting a phone call. It is an effective method: According to Herber-Downey, they initiate contact 75% of the time.

Linn County’s decision to migrate online comes at a time when STI rates are increasing nationwide, money to combat them is decreasing, and individuals are using new technology to meet people and have fun. Leo Parker, director of prevention programs for the National Coalition of STD Directors, stated that the number of sexually transmitted infections (STIs) is rising much faster than the amount of funding available, while public health departments — many of which are underfunded — struggle with new behaviors.

“Social media firms have billions; we have tens of thousands,” said Dr. Jeffrey Klausner, a professor of public health at the University of Southern California and former head of STD prevention and control services in San Francisco. Due to the gap in financing, few public health agencies have online-accessible personnel. Klausner stated, “Really, only in big cities do they have somebody assigned to that.”

Even when departments have sufficient personnel to meet the problem, institutional support may be insufficient. Some public health officials inquire about employees who access the applications. Klausner once testified on behalf of a contact tracer in Ventura County, California, who was terminated for utilizing sex websites for work.

However, as individuals go online to find romantic relationships, it makes sense to follow them there. “We’re now in a digital era,” Parker added. Individuals may not be out or may mistrust their identification, making online venues cozy, anonymous locations for romance — which, in turn, makes it initially more difficult to approach them face-to-face.

Moreover, online communities such as Grindr are valuable public health instruments beyond contact tracing. They can be effective means of communicating public health problems.

Parker and the Linn County authorities reported that public service ads on dating apps — advocating for condom usage or providing the hours of operation for sexual health clinics — do appear to attract individuals to services. “People do come in stating, “I noticed that you offered free testing. I noticed it on Grindr’ “Parker remarked.

Jack Harrison-Quintana, the director for equality at Grindr, stated that the software pushes messages and information to its subscribers. Grindr bills itself as the largest dating app for LGBTQ+ individuals. During a 2015 meningitis epidemic among LGBTQ+ groups in Chicago, for instance, this participation escalated.

During the epidemic, the app distributed citywide vaccination notifications. Then Harrison-Quintana utilized the design of the service: Grindr employees targeted messages to specific communities using the site’s geolocation capabilities. “We might go block by block and ask, ‘Is this where the instances are occurring?’” he explained. If so, more messages were delivered to that region.

This initiative inspired the app to offer regular public health alerts on covid-19 and monkeypox to its network of around 11 million monthly users. Grindr now permits users to show their HIV status and vaccination status for coxsackie, monkeypox, and meningitis.

However, there are a few things that Grindr will not perform. The corporation prohibits public health agencies from creating institutional accounts. In addition, automated notifications regarding STI exposures cannot be given to users.

The corporation explained that this is due to privacy concerns, despite pleas from public health advocates for improved messaging capabilities. Grindr feels that a government presence on the application would be invasive and that even anonymous warnings would enable users to trace illnesses back to their source. (When asked about public health officials who join the site on their own, company spokesman Patrick Lenihan stated, “Individuals are free to say something like ‘I’m a public health professional — ask me about my work!’ in their profile and are free to discuss sexual and public health issues as they see fit.”)

However disheartening to some in the public health community, Grindr’s attitude represents a long-standing effort by the commercial sector to balance government concerns with consumers’ privacy rights.

Klausner cited a syphilis outbreak in San Francisco in 1999 as one of his earliest examples of competing interests. The source of the epidemic was an AOL chatroom. Klausner stated that, based on his study, it appeared that people could go online and “find a sex partner faster than you can have a pizza delivered.”

But convincing New York-based Time Warner, AOL’s ultimate corporate parent, to participate was time-consuming and difficult; the New York attorney general’s office was necessary to acquire access to the chatroom.

Since then, the web sector has grown, according to Klausner. He assisted in the development of a mechanism for sending digital postcards to potentially vulnerable individuals. These postcards said, “Congratulations, you have syphilis.” “They were edgy postcards,” he remarked, adding that certain versions were less “snarky.”

Overall, he added, the world of dating apps is still “divided.” Apps that appeal to LGBTQ+ users are typically more useful for public health initiatives than those that cater primarily to straight clientele.

Jen Hecht, leader of Building Healthy Online Communities, a public health nonprofit collaborating with dating apps, noted that this is related to the community’s experience with sexual health. “People in the LGBTQ community have been thinking about HIV for what, 30, 40 years?” she said.

She stated that even while STIs impact everyone, “the standard and expectation” for straight-focused dating apps does not include them. Indeed, neither Match Group nor Bumble, two Texas-based companies with the largest heterosexual dating apps, replied to several requests for comment from KHN.

However, consumers, at least thus far, appear to value app-based treatments. Harrison-Quintana stated that Grindr has adopted a straightforward way to communicating health information. He has never gotten any criticism, “which has been quite pleasant.”

KHN (Kaiser Health News) is a national news organization that delivers in-depth health-related journalism. KHN, with Policy Analysis and Polling, is one of KFF’s three primary running programs (Kaiser Family Foundation). KFF is an endowed nonprofit organization that provides information on national health concerns.