How some — but not all — dating apps are taking on the STD epidemic

Many dating apps continue to ghost health officials and advocacy groups who seek their help fighting the epidemic of sexually transmitted diseases the platforms have helped bring about. Some of the sites, however, are starting to swipe right.

Even as rates of syphilis, gonorrhea, and chlamydia have climbed to record levels over the past few years, major dating apps and sites like Tinder have avoided taking action or even speaking up about the problem.

Recently, however, a handful of popular apps whose users are primarily gay, bisexual and transgender — the populations most at risk for STDs — have begun encouraging users to disclose their status, get tested and treated, and notify past partners if they may have contracted a disease.

Outreach and health promotion on dating sites can help control disease, but some companies “don’t want to associate their site with things like HIV or STIs,” says Jeffrey Klausner, an UCLA researcher who led STD prevention at San Francisco’s health department. “I think they’re concerned that the brand of their site would be somehow tarnished.”

Grindr, Adam4Adam, Daddyhunt and other companies have forged partnerships with local health departments and advocacy groups to send out targeted alerts about STD outbreaks, set up regular testing reminders, and direct users to a site where they can securely and anonymously send a message to former sexual partners informing them that they may have contracted an infection.

Apps make it easier to find a partner, so it isn’t surprising to see an increase in STDs with an increase in number of partners, although there's little data to show that app use equates to more STDs, health experts say. In any case, health workers on principle need to meet people where they are, and increasingly, that’s on their phones.

“If you’re a public health provider, you see a gay man for their health care maybe three to four times a year. But they’re on an app like ours every single day,” said Alex Garner, who heads the health team at Hornet, a social media app for gay men with about 1 million U.S. users and 26 million globally.

Jack Harrison-Quintana, the director of Grindr’s LGBTQ advocacy arm Grindr for Equality, says the company has incorporated more health features and resources over the past five years for its more than 4.5 million users as STD rates have climbed across the country.

But these partnerships so far lack the federal funding and widespread industry support needed to turn the tide on the STD epidemic. Some apps, for example, will only run public health messages as paid ads, Klausner said, and health departments, their budgets decimated since the 2008 recession, can’t afford to pay.

Public health groups and state officials have criticized big dating apps for not being more proactive about promoting sexual health. When the Los Angeles-based AIDS Healthcare Foundation posted billboards a few years ago depicting Tinder and Grindr as “digital bathhouses” where users are likely to contract a disease, Tinder sent a cease-and-desist letter. The company, which has tens of millions of users around the world, did not respond to multiple requests from POLITICO to discuss the issue.

Local health departments and advocacy groups have tried for years to cultivate relationships with the apps, said Dan Wohlfeiler, co-founder of Building Healthy Online Communities, which brings together academic researchers and health officials with dating apps that also include BarebackRT, BGCLive.com, GROWLr, POZ Personals, and Scruff.

Wohlfeiler’s group recently met for the first time with executives from Tinder. Such conversations can be delicate, he said.

“We don’t want to go in attacking them,” Wohlfeiler said. “Let’s find areas where we can make progress, where they get to run their business and we get to have the biggest public health impact possible.”

On the apps in Appalachia

In April of this year, Monongalia County, West Virginia saw its syphilis rate start to skyrocket, with rates of chlamydia and gonorrhea close behind. Unlike other parts of the state where the infection rate was primarily fueled by sharing needles for drug use, local health officials determined that men who have sex with men were the primary drivers. The number of infections was climbing, and the partners of infected patients were proving so hard to track down that the health department knew the methods it had used for years — putting up posters and leaving brochures at local bars and college campuses — weren’t going to cut it.

“That’s old school and doesn’t get traction,” Lee Smith, the county health department’s executive director, told POLITICO. “Morgantown had one of the highest rates in the state, and we were seeing a huge percentage of syphilis co-infected with HIV. All the bells were going off and we knew it was time to do something.”

After hearing from a lot of patients that they had met partners on dating apps, Smith decided to reach out directly to the apps to help transmit information about the outbreak to the people most at risk of infection. Since syphilis, while potentially fatal if left untreated, often has no detectable early symptoms, public health workers wanted to sound the alarm to help diagnose people while the infection could be cured with simple antibiotics.

“Tinder was not willing to do anything other than give us the nonprofit advertising rate,” he said. “But we ain’t got no money, and we needed it for free. Thankfully the leadership at Grindr said, ‘We get it and we want our customers to be safe as possible.’ I said, ‘Bully for you! Public health heroes right here.’”

It was far from the first request Grindr had received from a local health department. Starting in 2015, the company has run free ads on its app alerting users in a specific state or geographic region about outbreaks of infections such as meningitis and hepatitis A.

“STIs loom so large for our community,” said Harrison-Quintana. “It's a universal concern for gay, bi and trans people. So it had to be a cornerstone of what we were doing.”

Starting on April 24 at 5 a.m., anyone in a 50-mile radius of Morgantown who opened the Grindr app saw a pop-up ad directing users to free testing and treatment options. After the first month, the ad ran monthly for paying Grindr members and bimonthly for free members. More than 70,000 people saw the ad over the next six months, and more than 3,500 clicked through to a resource page — far more than Smith could have reached through other methods.

The campaign had an impact. Local nurses reported that increased numbers of patients were showing up at STD clinics, with some specifically citing the Grindr ad as their motivation for seeking testing or care. “Then we can screen them for other things too,” Smith said.

The partnership with Grindr concluded at the end of November, but Smith said he plans to ask the state for funding to buy ads on other dating apps while exploring other online tools to fight the STD epidemic.

“But I'm not optimistic,” he said. “The state is running a deficit and public health is always the first thing they cut.”

Tapping apps’ potential

This October, CDC reported that cases of syphilis, gonorrhea, and chlamydia reached an all-time high in 2018. Syphilis jumped 14 percent in just one year and distressingly, newborn deaths related to congenital syphilis increased 22 percent. Federal health officials say an array of factors are fueling the epidemic, including decreased condom use, social stigma around STDs, and funding cuts to clinics that provide outreach, testing and treatment. Dating and hookup apps, used by tens of millions of people, have fueled the rising rates as well, officials say.

And while public health workers traditionally could trace sexually transmitted diseases within a local community and stop outbreaks before they exploded, “dating apps break down those social and geographic barriers, making STIs harder to track,” said Adriane Casalotti of the National Association of County and City Health Officials.

But the apps have also proven to be a powerful tool to fight the spread of STDs. UCLA’s Klausner co-authored one study concluding that Grindr was an effective means for distributing HIV self-testing kits. In another study, done in England, most participants said they wanted to receive sexual health information via dating apps.

In 2016, Grindr added sections to users’ profiles enabling them to disclose their STD and HIV status, their use of pre-exposure prophylaxis, commonly known as PrEP; the date they last had an STD test; and whether or not they use condoms. These features are aimed at helping users make safer and more informed behavioral choices — a challenge when anonymous hookups are common.

“People reported that while it was easier to have sexual health conversations on the app than in person, it was still not easy,” Harrison-Quintana said. “It's an anxiety-producing topic.”

Part of the challenge for apps has been crafting messages that don’t scare users or use condescending or judgmental language to describe sex. After partnering with Emory University and University of Washington researchers to gather data about what features and language put app users most at ease, Wohlfeiler’s group this year launched TellYourPartner.org — a site that enables people to alert their past and current sexual partners that they may have an STD, even if they don’t know the person’s name or location.

In 2020, Building Healthy Online Communities will kick off a pilot project to enable dating app users to order a free at-home HIV or STD testing kit that they can mail in for analysis. Health advocates say they hope to convince companies that these features will attract rather than scare away potential members.

In addition, "If an app owner makes a choice to encourage their users to get tested consistently, the likelihood of someone getting an STI on their platform is reduced," said Jen Hecht, a co-founder of Building Healthy Online Communities and a director at the San Francisco AIDS Foundation.