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Try out PMC Labs and tell us what you think. Learn More. Smartphone apps provide a new platform for entertainment, information distribution, and health promotion activities, as well as for dating and casual sexual encounters.

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research has shown high acceptability of sexual health interventions via smartphone apps; however, sexual health promotion apps were infrequently downloaded and underused. Integrating sexual health promotion into established apps might be a more effective method. The objective of our study was to critically review popular sex-related apps and dating apps, in order to ascertain whether they contain any sexual health content. The apps were downloaded to test functionality and to determine whether they included sexual health content. Part 1: Of the apps identified, 15 The majority of the apps did not contain any sexual health content.

Only 9 dating apps contained sexual health content, of which 7 targeted MSM. The majority of sex-related apps and dating apps contained no sexual health content that could educate users about and remind them of their sexual risks. Sexual health practitioners and public health departments will need to work with app developers to promote sexual health within existing popular apps.

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For those apps that already contain sexual health messages, further study to investigate the effectiveness of the content is needed. In recent years, the of smartphone users has surged across the world and downlo of smartphone apps have grown ificantly [ 1 ]. Smartphone apps provide a new platform for information distribution and networking.

Bythere were over 50 billion app downlo from the Google Play store, and more than 60 billion from the Apple iTunes store [ 34 ]. This platform creates various opportunities for health promotion activities such as distributing health-related information, offering resources for health care, and providing forums for sharing experiences [ 156 ]. The benefits of using apps for health promotion are many, including low cost to develop and operate, potentially widespread distribution, and convenience for both health care providers and health care seekers [ 1 ].

The availability of geosocial-networking smartphone apps—apps that use the global positioning system to locate their subscribers—has created a novel way of networking that is quick, cheap, and convenient [ 7 - 10 ]. Users can easily identify other users by physical proximity.

While these geosocial-networking apps can be used for forming friendships and building a community, they are frequently used for dating and to facilitate the process of finding sexual partners [ 781112 ]. By filtering user profiles, such as age, appearance, and interests, subscribers can select the type of partners they seek [ 13 ]. Grindr, a popular dating app that targets men who have sex with men MSMhad more than 7 million subscribers globally byand the is increasing [ 14 ]. studies have found that users of these dating apps report more sexual contacts and more casual sexual partners [ 7810 - 1215 ].

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Users also reveal ificant increases in casual sex since starting online dating [ 16 ]. The likelihood of young MSM engaging in unprotected anal intercourse was 3 times higher among Grindr users than nonusers [ 11 ], and users reported a higher prevalence than nonusers of ever being diagnosed with sexually transmissible infections STIs [ 9 ]. Sexual health interventions that are integrated with modern technologies have been successful [ 17 - 22 ].

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Text messaging has been widely used to promote sexual health, including appointment reminders, partner tracing, and result notification [ 22 ]. Studies of Internet-based human immunodeficiency virus HIV infection interventions targeting MSM using online questionnaires and tutorial sessions revealed a reduced rate of unprotected anal intercourse and increased condom use [ 2021 ].

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In recent years, due to the increasing use of smartphones, apps deed to provide sexual health information and education are readily available on the market [ 23 ]. However, these apps are infrequently downloaded, have low user ratings, and are unlikely to reach the target groups [ 23 ]. Rather than creating new sexual health apps, leveraging established and popular apps may improve the distribution of health promotion information to a larger of users [ 15 ].

Most important, integrating sexual health information within these apps can be an effective way to reach key populations, such as MSM or people who have casual sexual partners [ 1524 ]. Several studies have suggested that young adults consider this approach acceptable [ 101524 ].

The aim of this study was to systematically and critically review free sex-related apps including all apps that have sexual content, such as sexual entertainment, sexual health information, and sex enhancement and popular free dating apps, determine whether they contain any sexual health content, and, if so, what kind of information they provide to educate users about sexual health.

This review was conducted in 2 parts: a review of sex-related apps and a review of dating apps. Ethical approval was not required, as the research did not involve participants.

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The first part of the study was a content analysis of free sex-related apps. The search yielded apps from Android Google Play marketplace and apps from the Apple iTunes store.

We then excluded all the paid apps from the Apple iTunes store. We recorded the following information from the individual apps during the review: the app store category eg, health and fitness, games, educationthe app developer, and the user rating the average of individual user ratings of 1 to 5.

Chi-square or Fisher exact tests compared the main purposes of the apps and presence of sexual health content between iTunes and Google Play apps.

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The second part of the study was a review of popular dating apps. The first 50 free dating apps from each store were included. Apps requiring in-app purchase for basic functions such as receiving messages and online chats were excluded.

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We included an extra 3 lesbian dating apps that were available in both stores and had the most downlo according to the download s available in the Android Google Play marketplace. A female profile was created for each heterosexual app and lesbian app, and a male profile was created for MSM apps. We classified apps as containing no sexual health content and no safe dating tips if we found no relevant information after testing all the functions of the app, and logging in and out on 5 separate days.

Apps were categorized into 4 groups based on their primary target groups as heterosexual, MSM, lesbian, and other apps for seeking threesomes or group dates. Chi-square or Fisher exact test compared the presence of sexual health content between apps with different target groups. Our search yielded apps from the Android Google Play marketplace and apps from the Apple iTunes store.

Ultimately, apps were shortlisted for review Figure 1. A total of 15 apps We also recorded the of downlo of apps from Google Play marketplace; this information is readily available within the marketplace and is displayed in a range for example: between and We found that the 4 Android apps that contained sexual health information were downloaded less frequently than other sex aid or entertainment apps the of downlo is available in Multimedia Appendix 1. We included the first 50 free dating apps from each store, then excluded 25 duplicates from the list Multimedia Appendix 2. The sexual health content was displayed in the apps in four different ways Textbox 2.

Only 1 heterosexual app contained sexual health content Table 3. None of the 3 lesbian-specific apps contained any sexual health or safe dating content Table 3. Availability of sexual health content and safe dating tips in dating and entertainment apps according to target group.

Our review identified a large of smartphone apps that have sexual content or promote dating.

We found that the majority of these sex-related and dating apps contained no information about sexual health promotion. We chose to review all apps found using our search terms, regardless of app store category, rather than focusing on apps that aim to provide sexual health information and education.

The reason behind this decision was that research has shown that apps deed for educational purposes are infrequently downloaded and underused [ 23 ]. We made the same observation in our review.

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For example, Sexually Transmitted STDsan app that provides information about STIs, including definition, transmission, symptoms, treatments, and prevention, had fewer than downlo to January On the other hand, some game apps were downloaded far more frequently; for example, Bliss — The Game for Lovers was downloaded more thantimes from the Android Google Play marketplace this app is also available in iTunes. This finding demonstrates the advantage of integrating sexual health information within popular entertainment apps in order to reach out to more people.

Only 2 sex aid apps and 1 entertainment app contained sexual health content, demonstrating room for improvement. We hypothesize that exposing users to sexual health content while they are using these sex-related apps presumably while they are thinking about sex or during foreplay might be a good way to remind them of safe sex practices.

This hypothesis will need to be examined in future research. In the first part of the study, we found that 19 sexual apps had the primary purpose of providing support and information for sexual assault or violence. These apps offered a variety of information about topics including mental health support after sexual assault, prevention of sexual assault, and general information regarding sexual assault.

However, none mentioned the potential adverse sexual health outcomes faced by sexual assault victims.

Video transcript

The risk of unwanted pregnancy and contracting STIs, and steps that can be taken to prevent or treat these, are critical in the aftercare of sexual assaults [ 25 ]. Many victims of sexual assault do not seek help from health professionals [ 25 ]; therefore, providing such information via smartphone apps might encourage victims to seek medical advice for STI and pregnancy prevention.

The majority of these apps were targeted at an MSM population 7 out of 9. These findings suggest that there is more focus on the sexual risks of MSM who use dating apps than other groups. These geosocial-networking apps can potentially function as an entry point for HIV intervention delivery, assisting health professionals to reach the key populations, particularly where populations are hidden or difficult to access [ 715 ].

Delivering sexual health interventions via dating apps is an important area to be addressed in prevention of HIV infection. It is unfortunate that the opportunity to deliver messages to other groups via these apps is being missed. People who use dating apps seem likely to have more casual sexual partners than people who do not, which means higher risk of contracting STIs [ 13 ]. While sexual health content appears to be acceptable to MSM who use dating apps, its acceptability among other groups is unknown [ 1524 ]. More work needs to be done to increase the sexual risk awareness of users of heterosexual dating apps.

Each of these messages has its own limitations in reminding users of their sexual risk. If the frequency is too high, it might desensitize users. Messages appearing during chats could cause annoyance, which could lead to users unsubscribing and turning to other apps that exclude these kinds of messages. These disclosures may also expose users to stigma and discrimination or cyberbullying [ 29 ]. In the 2 apps that enabled indication of preference for safe sex practice, the concept was not defined.

Third, in-app blog posts can be a good place to display information regarding STIs and HIV if these posts are updated frequently and the information provided is correct. On the other hand, having links to sexual health clinics in the websites rather than within the apps might be less effective, since users have to be actively looking for sexual health information and using the website at the same time to be exposed to these messages.

This type of message is less likely to effectively remind users about their sexual risks. We identified another potential platform for intervention during the app review: the advertisement space within apps. Advertisements mostly exist in two forms: pop-up and that appear on the bottom of the screen; users can close pop-upbut they usually cannot remove bottom-of-the-screen. Once users click on thethey will usually be directed to a new that contains more information about the product being advertised most likely another paid app.

Health promoters could purchase these ad spaces to display sexual health information or links. Some app developers sell ad spaces as pop-ups for advertisers to purchase.

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