E-cards are last-minute lifesavers when you’ve forgotten to send a happy birthday card. But they’re not the first thing you think of when you learn you have a sexually transmitted disease.

But since 2004, a free Web site, inSpot.org has allowed users to anonymously notify their partners to get tested for STDs such as HIV, gonorrhea, chlamydia and syphilis. The online program allows users to send an e-card anonymously, specifying the STD.

The tool exists, but do people use the STD e-cards?

Well, that depends.



A study published this month in the journal, Sexually Transmitted Diseases reports that most people don’t think of sending an e-card when they test positive for a STD. That really shouldn't come as a surprise.

“It appears to be that 90% of people said we’d really rather tell people in person,” said Mary McFarlane, one of the authors of the study. “It’s not very appropriate - They felt it was taking themselves too far out of the equation, taking that personal contact too far out of it in these cases. Most people were not convinced to use electronic communication of any kind.”

The e-cards from inSPOT.org deliver the news about possible sexual infection in many tones. Some are flippant: "You're too hot to be out of action. I got diagnosed with an STD since we played. You might want to get checked too." Others are much more serious.

The study took place at the Denver Metro Health Clinic, the largest clinic for STIs in the Rocky Mountain region. Patients who were diagnosed received contact cards to encourage their sexual partners to come to the clinic for evaluation and were also given a card about inSPOT.org that explained how to use the website.

Partner notification is crucial to stop the spread of infection to various sexual partners. That process has traditionally been handled by the health department, but their ability to do so has been waning with reduced funding.

Between August and November 2008, more than 500 cards about inSPOT were distributed to almost all of the gonorrhea, chlamydia, syphilis, and HIV diagnoses at the Denver clinic. They also advertised the e-card website on posters, flyers and the Denver clinic’s website. They also ran ads on a gay dating site called ManHunt, a local Denver newspaper and a radio public service announcement.

Their findings: The use of the e-cards was low. In surveys, recognition of inSPOT was low (6%).

Also, their survey showed that 89% preferred to inform their partners in person – and only 4.8% said they would use e-mail.

Study authors concluded that the program “did not yield evidence for its effectiveness.”

“I don’t think it has proven to be scaled up to other areas as easily as we might think,” said McFarlane, prevention partnerships coordinator for the Centers for Disease Control’s Division of STD Prevention.

Innovation and new technology is important in this field, she said.

“It is important when you find these new technologies, before huge amount of public health dollars are spent, you need to make sure it scales across different populations. This particular one didn’t scale across the population. It’s important to know why not, so we can do better on the next innovation."

Deb Levine, executive director of ISIS Inc. which created inSPOT, said the Colorado study is flawed.

The e-cards were meant to be peer-to-peer tool rather than a health department tool. Plus, the social marketing of the cards were aimed to the gay community. When that marketing was given to regular attendees of the Denver clinic, who were vastly heterosexual, the marketing failed to reach the targeted community, Levine said.

The e-cards were created in the Bay Area, in response to a rise of syphilis in the gay community. Most of their users were gay men. They found that far more e-cards were sent for syphilis, than chlamydia. And syphilis affects more gay men and chlamydia affects more African American women.

“We think the study was flawed,” said Levine. “We still feel the e-cards have not been evaluated properly.”