Mobile Phones That Test for STIs Could Increase Infection Rates

Is lowering the gonorrhea rate worth risking an increase in HIV?

British firms have sunk millions into new technology which will enable people to test themselves for Sexually Transmitted Infections (STIs) using their mobile phones and a chip they purchase for less than $2. The motivation behind the initiative is to encourage STI testing with a goal to reducing the nation’s high STI transmission rates among the younger population.  A worthwhile goal, but what happens if the test leads to riskier sex? If it does, then the investors will have overestimated the new technologies benefit to society.

Essentially, this is how investors in this product envisage its usage: A young man or woman who is concerned they have an STI, but is nervous about going to a (free) clinic to be tested, will go a buy a chip (for about $2) to self-test. They will either pee or spit on the chip and then insert it into their mobile phone. In a matter of moments the nanotechnology in their phone will tell them if they have an STI. This will cause them to go to the same clinic they were too nervous to go to moments before to be treated. Perhaps, on the way, they will stop to notify their recent sexual partners that they have been exposed to an STI so they too can pee on a chip and insert it into their phone. Our hero will then only practise safe sex until they are certain they are clear of infection (perhaps they will buy another chip to determine this). Before you know it, the nation’s STI rate has been cut in half (this is, in fact, their prediction).

Here is how I envisage this product’s usage. A young man or woman has met someone in a nightclub with whom they would really like to have unprotected sex. They buy the chip at a vending machine in the club, as this is where investors intend to sell the chips, and insert it into their phone.  There are two possible outcomes.  The first is that discover that they are not infected with either of the diseases the phone can identify (chlamydia or gonorrhea) and they use this information to signal to their potential sexual partner that safe sex is not necessary. Their potential partner can then make a judgement as to whether or not a condom is necessary.

If people use the phone to signal their infection status and, as a result, condomless sex increases then maybe the infection rate of the diseases the phone detects falls, but the diseases the phone does not detect—syphilis and HIV just to name two—would increase along with unwanted pregnancies.

The second possible outcome is just as concerning: The individual discovers that they do have an STI. I am not a medical doctor, but my guess is that patients feel pretty devastated when they are told they had an STI. Is it really good practice for people to receive this information late at night, in a nightclub when they are probably under the influence of alcohol? (This isn’t really an economic issue, but it worries me.)

The main point here is that before we argue that an innovation in technology will improve an outcome for society, we have to recognize that people often change their behaviour in light of new technology. 

In this case, that behavior change could come with a very high price tag. Is lowering the gonorrhea rate worth risking an increase in HIV? Maybe it is, but the question at least needs to be asked.

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