Influencers spreading sexual health misinformation: Study

When seeking advice on contraception or sexual health, a visit to the GP would seem the apparent path.
 
But a new US study suggests that for many young people, the first port of call is actually a growing online presence of social media influencers who are more likely to provide advice around ceasing hormonal contraception based on unsubstantiated research than information on safe sex.
 
Melbourne GP and long-time advocate for tackling online medical misinformation Dr Preeya Alexander, told newsGP she is ‘not at all surprised’ by the study’s findings.
 
‘I’ve had lots of people tell me that shared stories on social media have led them to question the use of contraceptives like the COCP [combined oral contraceptive pill] or IUD,’ she said.  
 
‘I see this play out on social media constantly and in my own consulting room.
 
‘While the patient has no issues with the device and is low risk for complications, social media makes them question their choice.’
 
The influencers tracked by the study all had between 20,000 and 2.2 million followers, and talked about their experiences with contraception, including hormonal contraceptive pills, injections and implants, and non-hormonal contraception such as condoms and fertility tracker apps.
 
Even though the majority (92%) said they were currently using or had used hormonal contraception, nearly three quarters said they discontinued or planned to discontinue, with the main reasons cited as ‘to be more natural’ and to improve their mental health.
 
Previous studies have examined the connection between hormonal birth control and depression, but the researchers say it remains unclear.
 
According to the study, around 40% of the influencers said they were using, or had used, non-hormonal birth control, with fertility trackers the most popular method.
 
Lead author, Emily Pfender from the Department of Communication at the University of Delaware, said the reliance on using fertility trackers for contraception is ‘potentially harmful’.
 
‘Tracking cycles may not be as effective at preventing pregnancy as hormonal birth control,’ she said.
 
‘What young viewers don’t see in influencer content is the amount of effort and meticulous planning that goes into tracking cycles.
 
‘Influencers’ videos that discourage the use of a highly effective option for birth control and fail to encourage using other forms of protection to prevent against pregnancy and sexually transmitted infections are a public health issue.’
 
On her own social media accounts, Dr Alexander said she ‘tries very hard’ to tackle misinformation and provide evidence-based resources for people to make an informed choice, including via a recently posted video directly combatting misleading posts about contraception options.
 
‘I try to remind people that what might work for someone else may not work for them and that each of us has a different set of scales on how we measure risk and benefit,’ she said.
 
‘For instance, for me, benefits of the COCP – like managing PMS symptoms and preventing deficiency and managing my cycle – outweigh the risks.
 
‘It’s a case-by-case basis and everyone needs to chat to a trusted health professional. Social media makes it appear that some of these things are black and white when we know from our time in the consulting room that it’s often grey, and people need to be given the options in a balanced manner to make an informed choice.’
 
The study authors say social media influencers can have ‘powerful’ persuasive impacts on attitudes and behaviours, hence the need to examine ways in which they convey sexual health information, such as contraception.
 
Ms Pfender also notes the importance of young people critically evaluating the health information they receive on social media and the source of the information.
 
‘They should be sceptical of taking a one-size-fits-all approach to health based on the information we find online,’ she said.
 
The authors concluded that the study results are concerning due to social media influencers’ high credibility and the ‘potential for parasocial attachment’, and the fact that social media is the primary source for young adults’ sexual health information.
 
‘Future research is needed to understand the effects of influencers’ birth control content on sexual health behaviours,’ they write.
 
For Dr Alexander, she vows to continue on her mission to combat medical misinformation and provide safe and effective healthcare.
 
‘The misinformation on many health topics is exhausting on social media,’ she said.
 
‘I keep saying this, but the more qualified voices in this space the better.’
 
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