Rhode Island’s Department of Health announced a sharp uptick in cases of sexually transmitted infections. Some have chalked it up to the increasing popularity of so-called hook-up apps like Tinder and Grindr. But I've been discovering that the evidence for that is not so clear-cut. I joined Rhode Island Public Radio's Elisabeth Harrison to talk about it. Here's a transcript of our conversation, plus a link to listen to the audio.Kristin Gourlay talks with Elisabeth Harrison about the uptick in new cases of sexually transmitted infections and whether social media is to blame.
LIS: So Kristin, let’s just recap this news, that Rhode Island is reporting significant increases in new cases of gonorrhea, syphilis, and HIV. Who’s being affected? And how significant are these increases?
KRISTIN: The Rhode Island health department says that between 2013 and 2014, new cases of HIV and syphilis increased at a faster rate among men who have sex with men. And they say HIV, syphilis, and especially gonorrhea are also disproportionately affecting African Americans, Hispanics, and young adults.
The numbers aren’t huge, but the trends are pretty striking. New cases of syphilis went up nearly 80 percent in one year. 10 years ago, there were fewer than 30 new cases of syphilis in Rhode Island. Last year we saw 120 new cases. Gonorrhea cases have doubled. New HIV cases are up more than 30 percent after a period of decline. But just last year, they shot back up.
LIS: OK, so there’s a big spike in new cases of sexually transmitted infections in Rhode Island. The big question, though, is why? What does the health department say is behind the uptick?
KRISTIN: Health department officials point to a few factors– and they add this is a nationwide trend. One factor is simply that we’re uncovering more new cases because we’re testing more people. Another is that people are engaging more often in risky behavior – like having casual or anonymous sex, and not using a condom. And they mention the growing popularity of social media to do this –apps like Tinder or Grindr that help people find sexual partners quickly and easily. You might have seen some of the headlines like “Rhode Island blames Tinder for rise in STDs.”
LIS: Is there something to that theory, that social media, meaning apps like Tinder, are partly to blame?
KRISTIN: I decided to go looking for the evidence. I reached out to Dr. Amy Nunn, who runs the Rhode Island Public Health Institute, and Dr. Philip Chan, who runs a sexually transmitted infection clinic at the Miriam Hospital in Providence. They’re doing some ongoing research funded by the National Institutes of Health into some of these very questions. The bottom line: they tell me there is no solid evidence that Tinder or Grindr are directly to blame for the increase in new cases of HIV, syphilis, or gonorrhea. In fact, they say it’s really difficult for researchers to make that association.
But, they say there is a lot of evidence that people who use apps like these tend to engage in riskier sexual behavior. We’re talking about anonymous sex, sex with multiple partners, unprotected intercourse, that kind of thing. Also, they’re finding that it’s not necessarily Tinder or Grindr. They’re discovering that, especially with men who have sex with men, they’re using other social networking sites to find sexual partners. The point is that all of this online networking is enabling people to find partners faster, and it’s creating – as Amy Nunn called it – these dense networks of sexual partners where infections can be transmitted much faster.
LIS: Kristin Gourlay, is there any evidence that this population is not using condoms as often? I mean, that’s one of the most effective ways to protect yourself.
KRISTIN: Nunn and Chan tell me there’s conflicting evidence on this. Some studies find lower rates of condom use, some find higher use. I just spoke to a researcher from the University of Southern California about a survey they conducted on a small sample of men who have sex with men that found about 15 percent aren't using condoms. But what they really wanted to emphasize is that whether or not people are using condoms, finding partners online, or engaging in risky behavior isn’t what public health officials should be focusing on. Rather, they say we should be focusing on treating people and reducing the reservoir of infections. That means the number of people who are infected and don’t know it, people who could continue to transmit the disease to others. They emphasized that people should get tested, and there are lots of free or low cost places to do that in Rhode Island.
LIS: Kristin, a final question for you: it sounds like public health officials are trying to ramp up efforts to reach men who have sex with men with messages about prevention. But are there efforts underway to reach other groups, like women, or even adolescents?
KRISTIN: Actually, there is a movement underway in the health care community in Rhode Island to focus more on adolescents. We’ve seen a big push for more primary care, more preventative health care for adults and young children in the past few years. But some feel adolescents have kind of been left out of the conversation. And they have different needs. Recently the Miriam hospital and the Rhode Island Foundation helped convene a group of local teens and health care providers to investigate those needs and find some better ways to address them. One big takeaway from their work is that primary care doctors should be talking about sexual health and safety a lot more with teens.