Internet treatment of sexually transmitted infections – a public health hazard?

We conducted a systematic internet search using five different search engines in February 2007. The search term included the words "self treatment" and the name of six different common STIs. We visited the vendors' websites and recorded any information on the formulation, adverse effects, cautions, and prevention of infection.We identified a total of 77 treatments from 52 different companies, most of which were sold from the UK and US. The available remedies were predominantly for topical use and consisted mainly of homeopathic remedies. Only a small proportion of the web-listed products gave details on adverse effects, contraindications and interactions (22%, 25% and 9% respectively). Similarly, web vendors seldom provided advice on treatment of sexual contacts (20% of chlamydia and 25% of gonorrhea treatments) or on preventive measures (13%). Conversely, evidence of effectiveness was claimed for approximately 50% of the products.While treatments for certain STIs are widely available on the internet, purchasers of such products may potentially suffer harm because of the lack of information on adverse effects, interactions and contra-indications. Moreover, we consider the paucity of preventive health advice to be a serious omission, thereby leading to patients being needlessly exposed to, and potentially re-infected with the causative pathogens.Although the incidence of sexually transmitted disease (STIs) has decreased over the past few decades in Western Europe, recent years have seen a reversal of this trend [1]. For instance, there has been an increase in notifications of Chlamydia trachomatis, secondary syphilis, genital warts and genital herpes in the UK over the past years [2].One of the major barriers in the management of sexually transmitted infections is the associated stigma that may prevent patients from seeking professional medical care [3-5]. While media campaigns may lead to enhanced general awareness of STIs, patients who shun the spotlight may turn t