People from ethnic minority groups, such as Black, Asian and minority ethnic (BAME), are disproportionately affected by sexually transmitted infections (STIs)/HIV and experience challenges accessing sexual health services due to discrimination, stigma, and a reluctance to address sensitive issues related to their sexuality. The Department of Health has identified reducing STI/HIV rates as a priority for improving sexual health and recognised ethnic minorities as being vulnerable to these infections.
Why do we need to do something?
Home-based and online STI/HIV screening services are increasingly used within the
NHS, yet they fail to take into account the cultural distinctiveness of minority groups and the difficulties they face. This results in lower screening uptake and lower use of clinical interventions and therefore contributes to enduring health inequalities. In partnership with community-based organisations, our team has designed and piloted an automated chatbot, called Pat, to improve knowledge of STIs/HIV and promote online screening services. For our chatbot to make accurate recommendations, users need to disclose personal information about their sexual behaviours. We now seek to make our chatbot culturally appropriate, acceptable, and easy to use for ethnic minorities.
What are we doing?
We are currently conducting a large-scale survey examining what personal information people from ethnic minorities would be comfortable disclosing when using sexual health chatbots. We will then conduct face-to-face interviews to further explore the most appropriate chatbot questions for accurate estimation of individual STI/HIV risk and screening recommendations. We will also consult sexual health workers, chatbot developers and commissioners to understand how to develop and implement culturally sensitive chatbots to support NHS sexual health services. Finally, we will optimise and test our chatbot through an online simulation study, promoting it on social media and social networking sites visited by ethnic minorities.
What are we measuring?
We explore the views of ethnic minorities and healthcare professionals to customise our chatbot and validate our concept. We will assess whether users would be willing to disclose personal and health-related information such as the number of sex partners, sexual orientation and ethnicity to determine the chatbot’s abilities to estimate personal susceptibility to STI/HIV. Our simulation study will assess chatbot overall performance, user engagement and characteristics, intentions to test for STIs/HIV and uptake of an STI/HIV test.
Who are we working with?
Community organisations and relevant patient and public groups advise us on every stage of our research and chatbot development. They co-design the research, co-produce our intervention materials, such as updating the chatbot script and contribute to the dissemination of our findings. This research will enable our chatbot to serve ethnic minorities and reduce hesitancy for STI/HIV screening in those at higher risk of infection.