Use of Electronic Personal Health Records as a Health Risk-Reduction Discussion Tool

Sexually transmitted infections (STIs) are disproportionately high among black youth ages 15-24. Innovative prevention strategies are needed to reduce the burden of HIV and other STI disparities among this population. Personal health records (PHRs) enable remote access to HIV and STI testing information that black youth may share with sexual partners during risk-reduction discussions. Despite the critical preventive value of risk status self-disclosure, little is known about how this group perceives the utility of having HIV and STI information available to share via PHRs. With mobile device accessible PHRs, black young adults may incorporate this technology into interpersonal and social situations such as sexual encounters.

The Electronic Sexual Health Information Notification and Education (eSHINE) study examined perceptions of PHRs as an STI discussion tool in a sample of young black adults ages 18-25. The eSHINE Study took place at Morgan State University, a historically black university and urban research institute located in Baltimore, MD. The project used a two-phased research design. The grounded theory phase explored perceptions of 35 students on incorporating mobile device accessible PHRs into contextualized risk-discussion practices. The second phase, an online cross-sectional survey, measured the distribution of and relationships between emergent themes for 354 students.

The specific aims of the project were as follows:

• Explore perceptions of using PHRs as a sexual health, HIV, and STI risk-reduction discussion tool. 
• Develop an integrative behavioral model for intentions to utilize PHRs for HIV and STI risk-reduction discussions. 
• Conduct a cross-sectional study to determine how differences in perceptions and other variables account for variability in intentions to utilize PHRs for sexual health, HIV, and STI risk-reduction discussions. 

Researchers found that PHRs may serve as a digital health tool for individuals to overcome barriers and initiate conversations with partners about sexual health. One of the most significant findings was that participants with unhealthy practices, primarily those who had not practiced risk discussions, believed that PHRs would encourage conversations with partners about risk and testing before sex. PHRs create a platform for the mutual exchange of information, and although they may not remove the awkwardness of having the conversation, they are believed to make them easier. PHRs also stand to increase patient engagement in sexual health, improve knowledge on STIs, and improve the patient-doctor relationship.