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Doctors have developed a new technique with which to tackle the problem of sexually transmitted infections (STIs).

At the moment when a patient is diagnosed with an STI there follows a laborious contact-tracing process intended to track down, warn, test and treat other partners who might be at risk.  This is a very time consuming and costly exercise but is absolutely critical from a public health perspective.  Some patients also find it embarrassing.

Human pap smear showing clamydia in the vacuoles at 500x and stained with H&E.Now, writing in the journal PLoS Medicine, Deb Levine and her colleagues from the Internet Sexuality Information Services, present the electronic answer - a system of anonymous e-postcards that alert recipients to what they might have picked up at a party recently. 

Their web-based initiative called inSPOT, which stands for Internet Notification Service for Partners or Tricks, is a website with a difference. Users choose from a range of online "greetings" cards which they then customise by selecting the infection with which they have been diagnosed.  They can also add a short message if desired.  The cards are then sent anonymously via email to recipients identified by the patient.  When the recipient receives the e-card it pops-up links to information about the disease they might have caught or be carrying together with a list of the nearest places to seek treatment or advice.

Since the system was first launched in San Francisco in 2004 nearly 50,000 e-cards have been sent.  It has since been scaled up to many other cities and translated into other languages.  About 50% of recipients of the e-cards, it seems, also choose to avail themselves of the information provided when the cards arrive in their inboxes.

Although the system relies on patients knowing the electronic contact details of their contacts in order to warn them, the team point out that large numbers of cases of STIs are now occurring amongst people who use the Internet to meet new partners and so, by definition, they usually already have this information. And with one person in ten infected with chlamydia in certain age groups and rates increasing by 100% per year in some areas, this initiative could help to stem the epidemic. But let's just hope that no one starts using it to spread computer viruses!

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