Abstract

Objective: To trial a novel method of sexual health promotion - sending email and mobile phone text messages (SMS) about safe sex and STI to promote reductions in STI behaviours and increases in STI knowledge and testing.

Methods: Young people (aged 16-29) were recruited at a music festival in Melbourne. They completed a questionnaire about sexual risk behaviour and were randomised to either the intervention arm of the study (to receive messages) or a control group. Text messages were sent every 3-4 weeks for a twelve month period and included catchy STI prevention slogans. Emails were sent monthly and contained detailed information about STI topics and links to related websites. Participants completed follow-up questionnaires online after 3, 6 and 12 months. Clustered weighted estimating equations were used to compare outcomes of the two groups.

Results: 994 people completed at least one questionnaire (507 in the intervention group and 487 in the control group); at baseline 58% were female, the median age was 19 years and 82% had ever had sex. At 12 months, STI knowledge was higher among the intervention group for both males (OR 3.19, 95% CI 1.52, 6.69) and females (OR 2.36, 95% CI 1.27, 4.37). Females in the intervention group were also more likely to have discussed sexual health with a clinician (OR 2.92, 95% CI 1.66, 5.15) and to have had an STI test in the past 6 months (OR 2.51, 95% CI 1.11, 5.69). There were no significant differences in condom use between the groups. Respondents' opinions of the SMS and emails were positive.

Conclusions: Receiving regular sexual health-related SMS and email messages can improve knowledge in young people and health seeking behaviour in young women. SMS and email are low cost, widely available and convenient, which - when combined with their popularity among youth - means that these media have considerable potential for sexual health promotion.