STDs.com: Sexuality Education Online
Dr. Sarah N. Keller
Dept. of Communication & Theatre
MSU-Billings
• Objective
– To identify the educational messages and
usability features of safe sex web sites that are
important to teenagers.
• Study contents
– How a small group of adolescents ages 14-17 rated five
sexual health web sites;
– How a larger group of adolescents ages 14-17 ranked
17 health messages on STDs.
• Findings
– Most of web sites failed to answer teenagers’ personal
questions about sexual health;
– Most messages received low scores in both the web
coverage and the importance to teenagers.
Background
• Increasing use of the
Internet for health
information:
– Many teenagers use the
Internet for
information on healthdiseases, clinical trials,
treatment and nutrition.
– 44% of teenagers learn
about sexual issues
from the Internet.
• Adolescent STD
epidemic:
– About one in four sexually
active youth in the U.S. are
infected with an STD by
age 24.
– Only 58% of sexually
active students reported
having used a condom
during their last sexual
intercourse experience.
Background (Cont’d)
• The Internet provides a unique opportunity for
teen’s sexual health education.
– offers anonymity and sophisticated message tailoring.
– Relays health information to youth who may not be
connected to health care services and lack
transportation.
– Promotes self-efficacy and model communication
skills, key components of healthy adolescent
development, and prerequisites to safe sex practice and
STD prevention.
• Previous studies:
– How teenagers use the Internet to learn about and
prevent STDs/HIV.
– Effectiveness of interactive health communication.
Phrases of this Project
• Phrase I:
– To look for the
strongest web sites of
36 teen-targeted safe
sex web sites.
• Content Analysis
• Five web sites were
identified as the
strongest web sites.
• Phrase II:
– To assess adolescents’
criteria for content of
sex education on the
Internet;
• Adolescents’
perceptions of the same
sites.
– To develop suggestions
for how this
information might be
improved.
Results (Phase I)
Websites
STD/HIV
(%)
Communication
(%)
Usability
(%)
Average
Score
(%)
1. www.nnfr.org/adolsex/fact/adolsex_std.html
82
33
45
53
2. www.unspeakable.com/truth.html
63
24
55
47
3. www.siecus.org/teen/
23
33
82
46
4. www.chebucto.ns.ca/Health/TeenHealth/
77
0
50
43
5. www.coolnurse.com
50
0
73
42
6. www.cdc.gov/nchstp/dstd/dstdp.html
59
0
64
41
7. www.cfoc.org/3_teen/3_stdsteens.cfm
27
33
55
38
8. www.itsyoursexlife.com
41
38
45
37
9. www.umkc.edu/sites/hsw/teens/index2.html
41
24
27
31
10. www.aidspartnership.org/teens.shtml
59
0
27
29
11. www.std.terrashare.com
32
19
33
28
Average of top 10 sites
55
20
54
Average for all 36 sites
33
9
44
Top 5 Web Sites
• Web sites:
www.nnfr.org/adolsex/fact/adolsex_std.html
www.unspeakable.com/truth.html
www.siecus.org/teen/
www.chebucto.ns.ca/Health/TeenHealth
www.itsyoursexlife.com
Method (Phrase II)
• Population
– Small group (n = 6) teenagers
– Purposive sampling:
• Boston’s Teenage Population
– 23% of the is African-American
– 13% is Hispanic
– 58% is Caucasian
• Cambridge Rindge and Latin students are 38% African-American; 14%
Hispanic; and 40% Caucasian
• After-school program guaranteed Internet access
Measurement (Cont’d)
• Sexual health criteria
– Sexuality and Information Council of the
United States (SIECUS)
• To inform offline curricular development in
sexuality education nationwide.
Score sheet for students’ opinion on how well each web site covered each topic.
Topics about sexually Transmitted Diseases
(STDs)
More than on STD
HIV transmission by casual contact (e.g. hugging or shaking hands)
HIV transmission through kissing
Talking about STDs with a partner
How to avoid STD/HIV
Condom effectiveness
When to go to a clinic
How to get counseling
Which STDs can be cured or treated
Support groups for HIV positive people
STD/HIV Testing
Reinfection
What to do if infected
Getting support from friends & family
STD/HIV hotline information
Information about Hepatitis B
Helping others protect themselves
Total Scores
Web sites
1
2
3
4
5
Criteria
Question
Response
1. Accuracy
•Ability to determine
who wrote the site
•Dose the author provide e-mail or contact
number?
•Clarity of purpose
•Can you tell the purpose of the site and why
it was produced?
2. Authority
•Qualifications
•What credentials are listed?
3. Objectivity
•Goals of the site
•Dose this site seem to be a mask for
advertising?
•Detail of information
•Which opinions are expressed?
4. Currency
•Up to date links
•How many dead links on site?
•Current updates
•Is site updated regularly?
•Currency
•Is the information outdated?
Sample American Library Association standards applied to various web sites. From Kapoun, J. (2000). Teaching undergrads web evaluation.
College & Research Libraries News. Retrieved Jan. 21, 2003 from http://ala.org. Adapted with permission of authors.
Results – Student questions
Students’ Questions
How long does it take for the pill to kick in?
Can a condom protect you from getting STDs
when you have sex with a person carrying it?
Can you get HIV through kissing?
Can you still get pregnant if the condom is rip?
Why is sex so complicated?
What is the difference between making love and
having sex?
Can you get pregnant with your clothes on?
Total Scores
Web sites
1 2 3 4 5
X X
X X
X
X
X
X
Results – STD topics
• Top four topics:
Web sites
STD topics
1
2
3
4
5
Average
scores
Which STDs
can be cured or
treated
7.6
7.4
6.4
5.4
8.6
7.08
Helping others
protect
themselves
6.6
7.0
7.2
7.6
6.8
7.04
How to avoid
STD/HIV
6.2
7.8
7.6
5.4
5.4
6.48
STD/HIV
Testing
7.4
7.4
5.4
5.6
6.6
6.48
From Table 2.Average scores representing students’ opinions of how well web sites covered STD
topics (on a scale 1-10)
Results – STD topics
• Three weakest topics:
Web sites
1
2
3
4
5
Average
scores
Reinfection
1.4
2.4
2.6
3.2
1.8
2.28
Support groups
for HIV
positive people
2.8
3.6
4.6
3.8
3.2
3.60
How to get
counseling
4.2
6.2
5.0
4.2
2.4
4.40
STD topics
From Table 2.Average scores representing students’ opinions of how well web sites covered STD
topics (on a scale 1-10)
Results – Web site performance
10
Best web site: www.unspeakable.com/truth.html
Worst web site: www.itsyoursexlife.com
Average Scores (1-10)
9
8
7
6
5
4
3
2
1
0
1
2
3
4
5
6
7
8
9
10
Topics
11 12
13 14 15
16 17
HIV transmission
by casual contact
HIV transmission
through kissing
STD/HIV hotline
information
Support groups
for HIV positive
people
STD/HIV Testing
More than one
STD
How to get
counseling
Information about
Hepatitis B
What to do if
infected
Talking about
STDs with a
partner
Helping others
protect
themselves
Reinfection
When to go to a
clinic
Which STDs can
be cured or
treated
Getting support
from friends &
family
How to avoid
STD/HIV
Condom
effectiveness
Importance of STD topics by weighted average
Result—Importance of STDs topics
3.78
2.71
2.84
2.93
2.93
2.94
3.13
3.19
3.22
3.27
STD topics
4.42
4.43
4.56
3.9
4.16
3.55
2.52
2
3
15
10
11
1
8
16
13
4
17
12
7
9
14
5
6
Result—On-line experience
Frequencies of online experience with health topics
50
45
43
40
37
37
35
35
31
31
30
25
22
20
17
23
24
18
15
11
10
5
0
How to find a
local health
clinic
Smoking
Violence
HIV or AIDS
9
5
12
1
Other
Acne or other
Eating
sexually
skin care
disorders
transmitted
diseases
2
8
7
topic
Information Pregnancy or Problems Depression Weight loss
on any
birth control with drugs or or mental
or weight
specific
alcohol
illness
gain
diseases or
illnesses,
such as
cancer or
diabetes
11
3
4
6
10
Results – Usability scores
• The highest scoring web site:
– www.nnfr.org/adolsex/fact/adolsex_std.html
– Total score: 52.5
• The highest scoring usability criterion:
– “Currency”
– Total score of average currency scores for each site: 41
• The lowest scoring criteria:
– “accuracy”: 30.5
– “Objectivity”: 30.5
Results – Open-ended questions
• Sexual health
• Recommendations
• Web sites
Conclusion
• Application of the measurement:
– The results imply that our measurement tool
(coding sheet) for web analysis is reliable and
valid.
– The tool may be applied by multiple users
analyzing sexual health content over time.
• Little information on reinfection, how to get
counseling, and support groups for HIV
positive people was identified in the web
sites.
Conclusion (Cont’d)
• Generalization:
– Students of this project had positive response
on sexual health information.
– It is likely that other students, with more
Internet access, would be more favorable.
• Further designs:
– To identify top-notch safe sex web sites for
students;
– To disseminate or advertise information about
these sites to students.