Use of patient portals to disclose STI test histories to sex partners among U.S. men who have sex with men: A call for research and guidance.

Abstract

Background: This study investigates the use of patient portals for disclosing sexually transmitted infection (STI) test result histories to sexual partners among men who have sex with men (MSM) in the United States.

Methods: Using data from the 2022-2023 American Men's Internet Survey, this cross-sectional analysis examined demographic, behavioral, and healthcare-related factors associated with MSM's utilization of patient portals for sharing STI test results. Participants (N = 2601) were surveyed on portal use, STI testing frequency, and partner disclosure practices.

Results: 18% of survey participants used portals to disclose a STI test result to parrtners, with higher prevalences among individuals aged 16-37 years old versus 56 years and older, black non-Hispanic (26.4%) versus white non-Hispanic (16.8%), and those reporting nine or more times being tested for STIs (30.1%) versus 1 to 3 times (7.5%). Participants reporting sex work (33.3% vs 17.7%) and HIV pre-exposure prophylaxis (PrEP) use (24.2% vs 13.0%) also had a higher prevalence of portal use for disclosure. Multivariable Poisson regression analysis with robust error variance showed that sexual behavioral stigma from family and friends [adjusted prevalence ratio (aPR) = 1.11; p = .04] also, being tested for STIs four to 8 (aPR = 2.21; p < .001) and nine or more times aPR = 3.42; p < .001) were significantly associated with prevalence of portal-based disclosure.

Conclusion: Findings suggest patient portals may be viable tools for STI prevention in MSM communities, especially among individuals with increased vulnerability to STI acquisition. Addressing disparities in portal access and explaining patient portal capabilities may enhance the role of digital health in reducing STI transmission among MSM communities.