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Tech

Do You Really Want to Use an App to Tell Someone You've Got the Clap?

Using technology to dodge difficult conversations just undermines the intimacy that sex is supposed to create.
Image: Shutterstock

In my mid-twenties, I got my first and only STI: an annoying collection of seemingly indestructible pimples known as molluscum. If you've never heard of molluscum, you're not alone: as a doctor once told me, the main reason anyone cares about molluscum is because it suggests possible risk for other, more serious infections. As sexually transmitted infections go, it's one of the most minor, a temporary annoyance rather than a life-debilitating condition.

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So it should have been easy for me to tell my partner about the waxy bumps colonizing my ass. And yet it wasn't: I felt a deep sense of shame that made it hard for me to say anything about my condition until months later, when it was all taken care of.

I'd like to think that, had my affliction been something more serious, I would have been a little more willing to open up and do some partner outreach and notification. But if I'm being honest with myself, chances are good I would have been just as nervous about disclosing a herpes or chlamydia infection as I was about my bout of molluscum. Studies of the lackluster rates of partner notification suggest I'm not not alone on that front—though a handful of companies are hoping that, with the right technology, that trend could change.

Using technology to dodge difficult conversations just undermines the intimacy that sex is supposed to create.

Partner notification is one of the key tools of STI containment and eradication. After all, if people don't know they've been infected, they're unlikely to get treated—and incredibly likely to keep on infecting others. But even after decades of education and awareness campaigns, rates of partner notification still hover around 52 percent, perhaps in part because strategies for encouraging and enabling notification haven't progressed much since the 1960s, when PSAs like VD: Name Your Contacts attempted to bore audiences into submission with unbearably repetitive storylines about the importance of telling the health department the name of everyone you'd ever boned.

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In an era where startups promise to fix every problem from hailing a cab to cooking dinner, it's easy to feel like the answer to our woes is just one app or website away. Could better technology—the Tinder, say, of partner notification—be the solution we've all been waiting for? If letting a partner know they may have been exposed to an STI were as easy as clicking a button, would more people do it?

At least two websites—So They Can Know and Don't Spread It—hope the answer is yes. Designed to facilitate anonymous partner notification, the sites give users the ability to send a text or email to a past (or current) sexual partner alerting them that they may have been exposed to an STI, and should seek medical attention as soon as possible.

There's no question that these services have struck a chord with people. Founded in 2012 by sex educator Jessica Ladd, So They Can Know has registered over 100,000 users in the past three years, a number made even more impressive given the minimal promotion the site's team has engaged in. And, for that matter, the relatively niche population of users they're appealing to: The CDC estimates there are about 20 million new STI infections in the US every year; no small number, but still a fraction of the nearly 250 million adults in the US.

So They Can Know offers a variety of options and help for notifying partners that one has contracted an STI.

What's more interesting than the site's popularity, however, is the fact most of those users aren't taking advantage of the anonymous notification feature. Rather than use the internet to eschew a difficult face to face conversation, many So They Can Know registrants are opting to take advantage of the site's educational side, digging through the database of tips and scripts for notifying a partner about an STI in person, online, or over text message.

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Ladd acknowledges that it's possible that the lackluster adoption of So They Can Know's anonymous notification may be a factor of site design. Since its launch, So They Can Know has done little in the way of A/B testing or optimization in an attempt to increase use of the anonymous notification service; perhaps an increased emphasis on the notification feature would lead to an uptick in usage.

Or perhaps it wouldn't. Maybe people aren't making use of the anonymous notification service, not because they can't find it, but instead because, ultimately, most of us don't want to tell a past partner about a possible STI through an anonymous, impersonal email or text. What if people aren't actually interested in a one-click solution to partner notification—just some anonymous technology to give us the education, confidence, and script we need to have that conversation ourselves?

So They Can Know wasn't around when I was dealing with molluscum, but if it had been, I don't think I would have used it. That same year, I found myself on the other end of the partner notification equation, feeling a tightening in my chest as I heard that some suspicious bumps residing on a partner's genitals had turned out to be HPV. It wasn't easy to hear that news, and it wasn't easy to have the conversations about safety that defined the rest of that relationship.

But maybe that's the point: dealing with the trust and safety issues that come with intimate relationships aren't always easy, and using technology to dodge difficult conversations just undermines the intimacy that sex is supposed to create.

On her end, Ladd isn't particularly troubled by anonymous notification's failure to launch. "We would prefer people to tell their partners themselves," she said. "We want them to look at the information about how to talk to their partners first, if that's something they're going to do, then they know that that information is there, and that might lower that barrier for them."

If So They Can Know is successful in that mission, Ladd will have created something far greater than she originally intended: a technology that fosters, rather than smooths over or helps us avoid, one of the most difficult conversations there is to have.