Friday, June 1, 2007

CheckTonight.com - hookup insurance?

CheckTonight.com is hooking up with online dating sites to provide negative test result verification. Well, so far, the list of participating sites isn't that impressive (Atomicmen being the biggest). While the move to do this among dating sites is good, there are some definite issues. It is also a bit disappointing that the group taking this plunge seems to vilify, if only slightly, anyone who may already be positive, with the prominent text: "Show You Tested Negative for HIV and Optionally Other STDs." It also offers zero mention of window periods.

Here's what signing up was like for me:
1. First join a lesser known hookup site (ha!)
2. Register at CheckTonight.com. (which includes downloading and faxing a HIPAA form).
3. Find a suitable place to get tested (you can use their search tool, or see a private doc).
4. If you choose one of the Labcorp testing sites, pick which tests you want. Here's the kicker for the insurance-less:
Full panel: HIV, herpes, Hepc, chlamydia, gonnorhea, syphilis $369!!Or you can choose specific ones. Syphilis alone is the cheapest at $32, chlamydia/gonorrhea is $174. And so on...
5. Then sign another HIPAA form releasing CheckTonight.com to receive your test results. (It's okay for minors to use the service, but an adult is supposed to sign the form, electronically though).
6. Enter credit card info, billing address.
7. I didn't go any further...but you get the point. A lot of steps.

Here's the list of steps in their words.

So what is promised after your test results are faxed back to CheckTonight.com?
1. Positive results are not kept or posted anywhere. A nice list of resources are given.
2. Negative results receive a badge (including test date) that can be posted on a very select list of dating sites, or a social networking site that accepts html (I'm assuming that it is a basic html badge).


So, my two cents are:
Can the badges be stolen, doctored and repasted elsewhere?
Why not encourage HIV+ folks to test for STDs?

I would love to hear comments about this from readers...

Update: Atomicmen has gone out on a limb to try something that some of us in public health have been asking for for a long time. Checktonight is imperfect, but Atomicmen's attitude and willingness to improve is on target:

"...CheckTonight ... is willing to work with Atomicmen on making the site more friendly so any feedback is welcome. I appreciate all feedback and knowledge and would encourage anyone to help in the education of those who are not understanding of anyones "fears", but that door swings both ways. I think that direct reaction to something with out investigation can also be fear based and should allow for the passing back and forth of ideas to make sites like CheckTonight more approachable to those who seem offended. Andrew at CheckTonight is willing to work with organizations to make his organization more open and honest in it's presentation..."

10 comments:

Alicia said...

I think this is a really interesting idea. You are right - my first concern would be if those badges or test results could be falsified in any way. Do you only get a badge if you are free of all STDs? Like you were mentioning if you do have HIV you may want to advertise that you are free from other STDs.

The other issue I could see coming would be if not having a badge would be a declaration that you do have STDs (after they catch on of course). Although maybe it would be a great tool to encourage generalized testing and treatment?

Phalligator said...

Thanks for your comments Alicia! It will be interesting to see what the uptake is. On the one hand, it's a nice risk for a hookup site to take and shows some awareness re: disclosure, serosorting, sexual networks, etc. But...I think the site needs to be rewritten considering the importance of continued testing if you are sexually active, as well as some words about how positive results are given. Are HIV+ results given online with only online resources available?

Stephan said...

Humm - personally I think this is great for STD - of course someone could falsify the document. Who knows what follow-up there is. But for HIV I see issues.

Having a stamp that says you are HIV- literately puts a stamp of approval on your status.

Everything I read says that it takes months for the anti body to show up – the tests that are generally given are for the antibody - it is very possible to be positive and test negative, especially if you are very sexually active.

To make matter more complex when a person is first infected with HIV they are most infectious.

Putting a stamp of approval on a negative test in a case where the person was actually just infected increases the risk to his partners a great deal if the purpose of the stamp is give some subtitle permission to practice anything but safe sex.

In this case a badge would put a label of SAFE on a person who was one of the least safe to be with at that time.

Alicia said...

Stephan is completely right - I have personally seen people test negative who within a month or two seroconverted. And the viral load is extremely high soon after infection.

I hadn't thought of that but it is a great point!

Anonymous said...

A few things:
* Atomic Men (formerly Sex4HotMen) has always been a sex positive, health positive website. They are good guys. They are trying to grow while caring for and being responsible to their membership, albeit small. I think they lost some membership with the name switch (many sites took "sex" out of their name).

* Health officials have been trying to get hookup sites to include information on the profiles about people's HIV status and last STD tests. It "seemed like" a good way to get people communicating about the continuum of safer sex. Hmmm.

* CheckTonight.com is highly problematic. They tried to get all the health depts. to buy in to their service, but everyone who reviewed it was disappointed. The service is potentially irresponsible as well - think of this scenario:
-- Date of last syphilis test - 5/31/07 negative
-- Since 5/31/07 I have been to a sex party,and had sex with my regular partner.
-- Even though 5/31 was only a few days ago, there has been a busy weekend in between. And that's just syphilis!

Bottom line, it's good that this is up for discussion.
Deb

Anonymous said...

From the beginning AtomicMen.com (even back when it was sex4hotmen.com) has taken pride in creating a community where members can be honest, open and direct. We encourage our members to share as much information as possible about themselves, so that other members can make an honest and thoughtful decision about meeting up. Information is power and the better-equipped one is, the easier it is to make an informed decision and minimize personal risk.

As stated by the recent post, we have always been a sex and health positive organization. We agreed to work with Andrew at CheckTonight because of his direct and honest approach to the subject. There is no way to guarantee a 100 percent clean bill of health from anyone. CheckTonight is not guaranteeing that, they are simply putting out there that getting tested, showing that you are taking the steps to get tested is a positive step towards being HIV and STD aware. Organizations get hammered for their unique approach to STDs and HIV whether by bringing the subject up before you have sex or sending an anonymous email from online sources like inspot.org after you have sex. Neither is perfect. What’s to stop a disgruntled partner from using inspot.org to send out a false STD email?

Most websites that offer “Dating” or “Sex” as a hook-up option ask for, in a check box or dropdown menu, your HIV status. Most choose to opt out or ASK ME, some choose NEG some Choose POZ. There is no guarantee that any of these are true honest answers to the “Are you HIV POZ or NEG?” questions. This current option to "brand oneself" does not seem to raise any eyebrows. Members choose to take this at face value as the right answer simply because that is what they are looking for their partner.

Personal responsibility for sexual behavior plays an important role here. We have all heard the stories of “he barebacked me and then told me he was POZ”. In some states this is now a criminal act. Does the sole responsibility rely only on one side of the sexual encounter? If so how then how is the “responsible side” decided? Personal disclosure verses personal wellbeing.

HIV and other STDs are an unfortunate reality for today's gay community. That is not to say we discriminate against members who have HIV, but it does mean that we will take every step possible to make sure that our actions (as webmasters) are not contributing to the spread of HIV and other STDs. We do not discriminate against men with HIV at all. However, in good conscience, we must take every step possible to prevent the further spread of HIV and STDs.

CheckTonight may be not what you are looking for. The system is completely voluntary. If you test negative, you can use CheckTonight’s small banner link in your profile that says “Sexual Health - click to verify”. Once you follow the “click to verify” link on that profile you are taken to a page at CheckTonight to log in or register to then send a request to that member for permission to view his information on CheckTonight. It does not discourage members from meeting other members who do not have a CheckTonight banner in their profile. There is no CheckTonight "label" on AtomicMen’s website that says you are HIV NEG.

Some of our members use AtomicMen for quick hook-ups and anonymous sex. Others use it for dating and potential long-term relationships. In order for us to make this a fun, safe and trustworthy site for all users, we provide tools to create honest profiles. We have options for "No PNP", HIV status, smoking, drinking, height, weight, etc. All of these represent voluntary information, which we ask our members to provide.

We try very hard to please our members and to make this a genuinely caring community. We have vast personal experience with HIV and we have never and will never discriminate against members with HIV.

David
AtomicMen

Phalligator said...

Thanks for your input David! Keep up the good work.

Andrew said...

Thank you for addressing the perceived challenges with CheckTonight.com. We appreciate the feedback on the issues and continue to listen to comments to improve our service. For example, we have now explicitly accounted for the window period in HIV testing in the "OUR TOUR" section of the site, so that it is more prominent.

CheckTonight's mission is to encourage routine testing for HIV and other STDs and to raise general awareness for the need to engage in safer sex practices. When paired with condom use, CDC has found this to be the most effective means of prevention. In the US, at least 25% of those already infected with HIV, do not know they have it and can unknowingly putting their partners at risk. We are simply providing a means for people to more efficiently share important health information and to provide a practical and socially driven incentive for people to test frequently. We also open the public dialog on HIV/STI awareness and prevention. We explicitly advocate condom use on nearly every page of our website.

There are two main issues:

CheckTonight creates a false sense of assurance and “brands people clean”

We do not do this. We only allow individuals to efficiently share negative HIV/STD test results with a secure and audited online system.
Let's put this into relevant context. Most major gay online dating websites provide a “tick box” where members may indicate whether they are HIV POZ or NEG – here there is no testing required and the site acknowledges that many people lie about their status to get more replies. In fact, I have spoken to many website owners who claim to “know that many who indicate they are negative on their profiles are in fact knowingly positive.” Why is there not a public outcry about this issue?

-We explicitly advocate condom use on nearly every page of our site – few other do this.
-CheckTonight is used in the clear light of day, with sound mind and sound reason; before the fits of passion takeover
-As for the window period in HIV testing, we have made this issue more prominent on our site. However, we cannot overly discount the power of the information from a negative test result so as to discourage testing in the first place. If a negative test result meant nothing because of the window period, CDC and nearly every other health professional would not encourage testing.

-Other such HIV prevention and serosorting campaigns suggest that testing is the “only way to know for sure that you are negative” – here there is a very weak account for the window period.

-each CheckTonight e-health certificate says in big black letters: “A clean test result cannot guarantee a clean bill of health”.

-We explicitly state that CheckTonight is not a guarantee, but serves as an additional layer of protection to condom use and other safer sex practices.

Security:
Currently people may carry around lab test results to share with their partner(s). These documents are very easily forged and this is highly impractical, especially when meeting online. This impractical and unreliable system is why people don’t ask their prospective partners for proof. It is also why there is little socially driven incentive to be tested in the first place.

CheckTonight employs similar encryption software to major online backs with 126bit encryption via Thawte certificates. We take steps to audit the integrity of the results to reasonably ensure that they were received from an accredited lab/physician and that they are correspondent to the correct individual.

It is possible for our security to be breached, just like major banks however, this becomes a police matter, where we will assist in the investigation. The alternative today is generally no information or unreliable information, where unscrupulous individuals can put others at risk, with little possibility of recourse.

3. We alienate those who are positive:
We don’t do this. Our mission is to prevent the spread of HIV/STDs and to raise public awareness.
We are considering allowing people to share positive results, but have reserved this option for fear that the scant possibility for security breaches and or other unscrupulous fraudulent activity and or slander could destroy people’s lives. Not allowing for the possibility of disclosing positive results eliminates this risk and leaves it to the individuals to disclose positive results at their choice and by their own will.

We may allow for those who are HIV positive to share other negative STD test results and remove the HIV negative test result (within 6 months) requirement for membership.

We could simply allow for people to test for whatever STIs they wish and share whichever results they wish. This will be explored.

Again, the greater mission is to encourage frequent testing and to raise public awareness for the need for HIV/STI testing. CheckTonight is a powerful tool to achieve this end and in and of itself, the option to employ an additional layer of personal protection when selecting sexual partners.

CheckTonight is a health credit check, where safer sex practices are still required.

Sincerely,
Andrew Unsworth
President
CheckTonight.com

Anonymous said...

Checktonight is a community of conscientious people and affiliates who are sincere in their effort as individuals to effect a positive contribution in preventing the proliferation of STD’s worldwide. Our members are real human
beings with unique opinions, emotions, lifestyles, and concerns.
Checktonight is proud to serve and welcome all those who agree that a
healthy sex life and the prevention of STD’s is a moral imperative. We liken our philosophy of STD prevention to “think globally act locally”.
The common goal of checktonight and its membership is not to concentrate on our differences as human beings, but rather to unite as one in our fight against the spread of stds in spite of those differences.
There are many dating sites which allow members to post their sexual health status both positive and negative to prospective mates. Checktonight is not solely a dating site nor do we encourage or discourage any type of lifestyle
or sexual orientation. We simply strive to provide a means to protect our members and others from the dangers of not knowing. We are proud of our members and affiliates; and to those we offer an independent service which
will ensure that our members are indeed health conscious and disease free at the time of their membership with checktonight. Together in our common plight as human beings with checktonight, we can make a difference to help
stamp out the reckless indifference of sexual indiscretion that leads to the spread of STDS worldwide.
You may find posts from individual members and blogs that are contrary to your own viewpoints. You may find site links on check tonight that you find objectionable. While we do not agree with certain individual blogs or posts we do not believe in censorship when it comes to one’s right to free speech
and sexual health. Everyone has a right to know that their prospective partner is disease free and health conscious. We at checktonight believe that it is also the responsibility of sexually active individuals to maintain an ongoing personal evaluation of their sexual health.

Mark

Deb said...

Since all of our goals seem to be to increase STD and HIV testing, readers should know that there are free and low cost clinics and testing sites available around the country.

If you call the National Centers for Disease Control's STD Information and Referral Line:
1-800-CDC-INFO (800-232-4636)
for help in English or Spanish
1-888-232-6348 for TTY service.
They will do a zip code search for clinics offering testing in your area.