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Acceptability of artificial intelligence (AI)-enabled chatbots, video consultations and live webchats as online platforms for sexual health advice
  1. Tom Nadarzynski1,
  2. Jake Bayley2,
  3. Carrie Llewellyn3,
  4. Sally Kidsley4,
  5. Cynthia Ann Graham5
  1. 1 Department of Psychology, University of Southampton, Southampton, UK
  2. 2 Sexual Health and HIV, Bart's Healthcare NHS Trust, London, UK
  3. 3 Primary Care & Public Health, Brighton and Sussex Medical School (BSMS), Brighton, UK
  4. 4 Solent NHS Trust, Southampton, UK
  5. 5 Psychology, University of Southampton, Southampton, UK
  1. Correspondence to Dr Tom Nadarzynski, Department of Psychology, University of Southampton, Southampton SO16 7PP, UK; tom.nadarzynski{at}


Objectives Sexual and reproductive health (SRH) services are undergoing a digital transformation. This study explored the acceptability of three digital services, (i) video consultations via Skype, (ii) live webchats with a health advisor and (iii) artificial intelligence (AI)-enabled chatbots, as potential platforms for SRH advice.

Methods A pencil-and-paper 33-item survey was distributed in three clinics in Hampshire, UK for patients attending SRH services. Logistic regressions were performed to identify the correlates of acceptability.

Results In total, 257 patients (57% women, 50% aged <25 years) completed the survey. As the first point of contact, 70% preferred face-to-face consultations, 17% telephone consultation, 10% webchats and 3% video consultations. Most would be willing to use video consultations (58%) and webchat facilities (73%) for ongoing care, but only 40% found AI chatbots acceptable. Younger age (<25 years) (OR 2.43, 95% CI 1.35 to 4.38), White ethnicity (OR 2.87, 95% CI 1.30 to 6.34), past sexually transmitted infection (STI) diagnosis (OR 2.05, 95% CI 1.07 to 3.95), self-reported STI symptoms (OR 0.58, 95% CI 0.34 to 0.97), smartphone ownership (OR 16.0, 95% CI 3.64 to 70.5) and the preference for a SRH smartphone application (OR 1.95, 95% CI 1.13 to 3.35) were associated with video consultations, webchats or chatbots acceptability.

Conclusions Although video consultations and webchat services appear acceptable, there is currently little support for SRH chatbots. The findings demonstrate a preference for human interaction in SRH services. Policymakers and intervention developers need to ensure that digital transformation is not only cost-effective but also acceptable to users, easily accessible and equitable to all populations using SRH services.

  • digital
  • eHealth
  • mHealth
  • AI

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  • Contributors TN and JB designed the study. CL, CAG and SK contributed to the analyses and the interpretation of findings. All authors contributed to the drafting of the manuscript and approved the final version.

  • Funding This work was funded by the University of Southampton and Solent NHS Trust.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data available on request from Tom Nadarzynski (