Advice from a medical expert through the Internet on queries about AIDS and hepatitis: analysis of a pilot experiment

Abstract

Background: Advice from a medical expert on concerns and queries expressed anonymously through the Internet by patients and later posted on the Web, offers a new type of patient-doctor relationship. The aim of the current study was to perform a descriptive analysis of questions about AIDS and hepatitis made to an infectious disease expert and sent through the Internet to a consumer-oriented Web site in the Spanish language.

Methods and findings: Questions were e-mailed and the questions and answers were posted anonymously in the "expert-advice" section of a Web site focused on AIDS and hepatitis. We performed a descriptive study and a temporal analysis of the questions received in the first 12 months after the launch of the site. A total of 899 questions were received from December 2003 to November 2004, with a marked linear growth pattern. Questions originated in Spain in 68% of cases and 32% came from Latin America (the Caribbean, Central America, and South America). Eighty percent of the senders were male. Most of the questions concerned HIV infection (79%) with many fewer on hepatitis (17%). The highest numbers of questions were submitted just after the weekend (37% of questions were made on Mondays and Tuesdays). Risk factors for contracting HIV infection were the most frequent concern (69%), followed by the window period for detection (12.6%), laboratory results (5.9%), symptoms (4.7%), diagnosis (2.7%), and treatment (2.2%).

Conclusions: Our results confirm a great demand for this type of "ask-the-expert" Internet service, at least for AIDS and hepatitis. Factors such as anonymity, free access, and immediate answers have been key factors in its success.

Figure 1. Homepage of elmundosalud.com

Figure 2. Home Page of the AIDS/Hepatitis Section

Figure 3. Example of an Answered Question on the Web

Translation of Question and Answer: Question on oral sex and the risk of infection: Dear Doctor Losa, although there are numerous questions addressing the risk of AIDS transmission through oral sex, I have not been able to find any referring to this risk when oral sex is given by a man to a woman. My question is: what are my chances of contracting AIDS if I give oral sex to an infected woman? Is there a way to perform this practice safely similar to the condom used by men? Thank you. Answer to the female questioner: The risk for either receptive or active oral sex is very similar in men and women. This risk ranges between 0.01% and 0.05%. No feminine condoms are available at the present moment, and the efficacy of microbicide agents (compounds active locally against HIV) has not been evaluated in this setting. JUAN EMILIO LOSA, expert on AIDS and hepatitis, Alcorcón Hospital Foundation

Figure 4. Number of Questions per Month