About our project

So They Can Know is a website that helps people who’ve been diagnosed with STDs to notify their sex partners, and then link those high-risk partners to testing and treatment services. This benefits:

• the patient by decreasing his or her chance of reinfection
• their partners by diagnosing them before they have too many health complications
• their community by decreasing the chances that those partners will give the STD to anyone else

The Problem We Help People Solve

Three of the most common sexually transmitted diseases (STDs) in the United States—chlamydia, gonorrhea, and trichomoniasis—can be cured with a single dose of medication. Yet they infect over three million American adolescents every year.

Partner notification — where people who’ve been diagnosed with an STD inform their past and present partners that they need to get tested — is one of the most effective and cost-effective interventions in STD control and prevention.

Unfortunately, only around 23% of at-risk partners are ever informed. Often patients are too embarrassed to start the conversation, or they worry their partners will think less of them. And because these infections are mostly asymptomatic, chances are that their partners aren’t getting tested on their own.

We want to help solve this problem by making it easier for people diagnosed with STDs to let their partners know they need to get tested. We’ve created a website, www.SoTheyCanKnow.org, that lets patients send anonymous e-mails. The e-mails tell recipients they may have been exposed to an STD, provide relevant health information, and link them back to the website to search for clinics and providers that provide STD testing in their area.

So They Can Know also delivers educational content, videos, and tips for patients who are willing to tell their partner themselves.

If we can get patients who’ve been diagnosed with STDs to notify their partners, we don’t just improve their health by preventing reinfection, we can help improve the health of the entire community by linking partners into care before serious health complications emerge and reducing the probability that they will spread the STD to someone else.

How it Works:

1. Alex gets diagnosed with an STD.
2. At the time of diagnosis, his doctor urges him to notify his partners and tells him about So They Can Know. Alex’s doctor gives Alex a card or a brochure, or provides a link to So They Can Know if Alex is getting his test results online.
3. Alex visits So They Can Know, navigates to the inform page, and decides whether to notify his partners anonymously or do it himself. He can watch videos about talking to his partner, download tips about how to have that conversation, take a quiz to help him figure out who he needs to notify, or read information about his specific STD. Alex can also send his partners anonymous emails.
4. If Alex decides to go that route, he selects his STD, previews the email message, and enters the email addresses of his partners.
5. Alex’s partners receive the email, open it, and learn that they may have been exposed to an STD, how the STD is spread, that they probably won’t have any symptoms, and where to get tested near them.
6. The “get tested” link navigates Alex’s partners to the Test Page, which allows them to search for a testing site near them, a doctor who takes their insurance through ZocDoc, or order a free self-collection kit through I Want The Kit.
7. Alex’s partners go get tested, get diagnosed, get treated, and then notify all their partners too.
8. Alex doesn’t get re-infected, Alex feels better, Alex’s partners don’t develop negative health outcomes, and their past partners get notified and future partners never get infected.

Clinical Proof:

We’re partnering with researchers at Johns Hopkins University to critically evaluate this service. Before developing So They Can Know, Johns Hopkins researchers surveyed 343 American adolescents on their likelihood of use and acceptance of anonymous email-based partner notification. Participants were randomized to hypothetical scenarios where they were either notifying a partner anonymously or being notified of a chlamydia diagnosis. Of hypothetical patients, 50% said they would be “very likely” to use So They Can Know if they were diagnosed and wanted to notify a partner anonymously, 32% said they would be “somewhat likely” to. Of hypothetical partners receiving a partner notification, 86% said they would be likely to get tested if they received an email from So They Can Know. These results are now being written up for publication.

Other studies have also found high acceptability of email-based anonymous partner notification, and two services in Australia that are similar to So They Can Know—WhyTest and Let Them Know—have had very promising results and high uptake. You can read more at:

• Bilardi, J., et al. (2010) Experiences and outcomes of partner notification among men and women recently diagnosed with chlamydia and their views on innovative resources aimed at improving notification rates.
• Mimiaga M., et al. (2008) HIV and STD status among MSM and attitudes about internet partner notification for STD exposure.
• Bilardi, J., et al. (2009) Innovative Resources Could Help Improve Partner Notification for Chlamydia in Primary Care.
• Bourne, C., et al. (2012) Promotion and uptake of a new online partner notification and retesting reminder service for gay men.
• Bilardi, J., et al. (2010) Let Them Know: Evaluation of an online partner notification service for chlamydia that offers e-mail and SMS messaging.

For more on the impact of partner notification on patient re-infection and on the importance of the notification of both casual and regular partners to combat disease spread:

• Brewer, D. (2005) Case-finding effectiveness of partner notification and cluster investigation for sexually transmitted diseases/HIV.
• Turner, K., et al. (2011) Costs and cost effectiveness of different strategies for chlamydia screening and partner notification: an economic and mathematical modeling study.
• Howell, M., Kassler, W., Haddix, A. (1998) Partner notification to prevent pelvic inflammatory disease in women. Cost-effectiveness of two strategies.
• Mathews, C., et al. (2002) “A systematic review of strategies for partner notification for sexually transmitted diseases, including HIV/AIDS.
• Ghani, A., Donnelly, C., Garnett, G. (1998) Sampling biases and missing data in explorations of sexual partner networks for the spread of sexually transmitted diseases.
• Rahman M., Fukui T., Asai A. (1998) Cost-effectiveness analysis of partner notification program for human immunodeficiency virus infection in Japan
• Kretzschmar M., et al. (2012) Effects of screening and partner notification on chlamydia positivity in the United States: A modeling study.
• Mercer, C.H., et al. (2011) Estimating the likely public health impact of partner notification for a clinical service: an evidence-based algorithm.
• Wasserheit J., Aral S. (1996) The dynamic topology of sexually transmitted disease epidemics: implications for prevention strategies.
• Heijne, J., et al. (2012) Insights into the timing of repeated testing after treatment for Chlamydia trachomatis: data and modeling study.

How We Help Patients:

Patients who notify their partners are less likely to be reinfected with a curable STD. We help patients by making an awkward, embarrassing, and difficult conversation a little bit easier, making it more likely that they will have a conversation that goes well and one that gets their partners tested and treated. For patients not willing to have that conversation with their partners, we can help them to do the responsible thing and notify them without having to reveal that they are the ones sending the message.

How We Help Doctors:

Often doctors find it hard to talk to their patients about notifying their partners. Our website provides doctors with a jumping off point for this conversation, and can act as a prompt or a guide, making doctors’ jobs easier and their care more effective. Doctors can either show the website to their patients themselves, or just give them a card or brochure that will link them to our service. Doctors’ patients will be happier because they now have the ability to notify their partners anonymously and a resource where they can learn more. And they’ll be healthier too, because they’ll be less likely to be re-infected, which will drive down healthcare costs and help your stats.

See Just Try It to the right and evaluate whether So They Can Know works for your patients.

How We Help Hospitals, Institutions, and/ or Medical Facilities:

It’s important for institutions to demonstrate good health outcomes for their patients. So They Can Know is designed to reduce the chance that your patients will be re-infected with an STD. Institutions providing in-person diagnoses can integrate So They Can Know into existing medical records systems, which could generate pop-up reminders to doctors to discuss So They Can Know with their patients and allow them to print out a page with the URL and a description of the website. Or institutions can order informational material about So They Can Know to give to their patients. Institutions delivering test results online can add in banner ads or links to So They Can Know for patients being diagnosed with STDs, and information about So They Can Know can also be recorded for institutions delivering test results by pre-recorded phone messages.

To have So They Can Know integrated into your EMR or other health information system please see the Integration Reward at the right.

How We Help Our Partners:

Our partners can get at the ground floor of an exciting new development in consumer-oriented care and treatment. Being a founding sponsor of an innovative new service that will be rigorously evaluated can be very good press, not to mention that partners will be instrumental in supporting an initiative that could dramatically reduce the incidence of STDs in the United States.

So They Can Know will increase demand for STD tests and treatment among the highest risk individuals, providing profit for manufacturers of diagnostic tests and STD treatments, and cutting long term costs for insurance companies by preventing re-infection and testing and treating sex partners early in their infection.

Our partners will gain access to an exclusive dataset that will provide insights to access to deidentified unpublished data to empower meta analyses that will lead to new understandings regarding the spread of STDs in communities. Cities that are seeking to identify all potential infected people can drill into the data with our geokit and determine their “hot spots” of STD transmission. Finally, our newsletter will highlight best practices and pass those around, helping everyone promote healthier. Our partners also get noted in the app and on our site, placing their brand right where potential clients would be.

How We Improve Public Health and Drive Down Healthcare Costs:

Raising rates of partner notification in a community can reduce the prevalence and incidence of STDs in that community. The denser the network, and the faster disease spreads, the better partner notification works to combat it. We can use the path of transmission of disease as a weapon against itself, empowering people that have been diagnosed to notify their partners, and bring the highest risk partners—at ten times the risk as the average STD clinic patient— into engagement with the healthcare system. Mathematical models show that if we raise rates of successful partner notification to a high enough threshold, we can eradicate certain curable STDs from entire communities.

We project that So They Can Know will prevent 3.4 million infections with curable STDs in the next ten years, saving more than $1.2 billion in direct healthcare costs.

For an intervention that costs less than $300,000 a year to maintain and promote, that’s not too shabby.

How We Will Spend Your Contributions:

We will use contributions to fund the creation of a mobile-friendly version of So They Can Know, an anonymous text messaging notification system, and pay for staff to maintain, continuously evaluate, and update the website in new and exciting ways.

• At MedStartr Goal level ($10,000) we will be able to launch SoTheyCanKnow.org.
• At $15,000, we will immediately start building out the mobile-friendly version of the website, to make it easy for smartphone users.
• At $20,000, we will begin formative research into a HIPAA-compliant secure anonymous text messaging system.
• For each additional $5,000 we will add in another video modeling effective STD partner notification with a past, present, or future partner. Vote for your favorite in the comments area to see which scenario gets filmed next for which STD! Or see Sponsor an STD Reward to choose your own.

Our Team Rocks!

Jessica Ladd, MPH: Founder / Executive Director, PhD Student in Infectious Disease Epidemiology at Johns Hopkins Bloomberg School of Public Health with a background in sexual health education and policy. http://www.linkedin.com/pub/jessica-ladd/32/1ab/865

Charlotte Gaydos, MS, MPH, DrPH: Chairwoman, Professor of Infectious Diseases at Johns Hopkins School of Medicine, the founder of I Want The Kit (www.iwantthekit.org), and STD researcher for over 20 years.

Stephan Adelson: Board Member, General Manager of Adam4Adam (www.adam4adam.com) —the most popular gay dating website in the United States—and former consultant of the National Coalition of STD Directors and numerous health departments on internet partner notification services. http://www.linkedin.com/in/sadelson

Lynn Barclay: Board Member, President and CEO at the American Social Health Association, with over 25 years experience in non-profit management. http://www.linkedin.com/pub/lynn-barclay/12/23b/14a

Mike Rushanan: Lead Back-end Developer, PhD Student in Computer Science with a concentration in health data security at Johns Hopkins University.

Jenny McManus, MPH: Director of Operations, with a background in HIV/AIDS research and community work with people recovering from addiction. http://www.linkedin.com/pub/jenny-mcmanus/44/579/2ab

To learn about the awesome members of our Advisory Board, visit us at http://sexualhealthinnovations.org/about.html and click on “Our Board”.

How to Find Us Online:

www.sexualhealthinnovations.org

Thank you for your Support!

Yours Truly,
Jessica Ladd, MPH
Founder / Executive Director
SexualHealthInnovations.org

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