Acceptability and Impact of a Customized Sexual Health Website Girltalk Among Young Pakistani Females

Background: Sexual health and cancer are sensitive issues for public discourse and communicating these topics is often controversial and restricted by socio-cultural factors. This is especially the case in conservative countries such as Pakistan, where strong socio-religious controls allay open discussion about sexual health and women's cancers, and limit young females' access to professional help for sexual health problems. At the same time, basic sexual health education is missing in school curriculums which has led to a significant knowledge gap about sexual health and also other topics related to women's health. However, exposure to Western lifestyle through internet and international media, and social factors like increasing age at marriage, indicate a growing opportunity for young people to have pre-marital sexual relationships, which increases the need for reliable and thorough information about sexual health. Due to gender imbalances in Pakistan, the situation is especially complicated for young females who, courtesy of cultural norms and social restrictions, are particularly uninformed about sexual health issues.

Program background: This study evaluates the effectiveness of a health information website "GirlTalk" that provides information about several topics related to sexual and women's health, starting with conditions related to condom use, STI prevention, and ending with breast and cervical cancer prevention. In addition, the site provides an online doctor service where young females can anonymously ask questions from female health professionals. The website was customized to young Pakistani females. When developing the website, a strategic framework of producing culturally sensitive health material (Kreuter et al 2003) was followed.

Evaluation Methods and Results: For this study, 200 students from three Pakistani universities were recruited using a convenience sample. A survey method was used to measure the participants' perception of the need and usability of the internet-based health information source. Perceived knowledge about three health topics (condom use, HPV vaccination and breast self-exams) was measured via pre- and post-test among the study participants. After the participants viewed the website, a 15-item scale was used to measure their satisfaction with the website, as well as their intention to use the website and to ask questions from GirlTalk's online doctor in the future. 

Conclusions: The current study is one of the first in the field that seeks to study the potential of web-based women's and sexual health interventions in ultra-conservative societies. The results of the study indicate whether young Pakistani females are ready to use web-based sexual and female cancer prevention information sources, and report if anonymous opportunity to ask health advice online would overcome the social, religious and cultural barriers against talking about issues related to sex and cancer. 

Implications for research and/or practice: The current study provides preliminary evidence of the acceptability and potential of a web-based health information source for hard to reach populations. The site provides a platform for research on sexual and women's health in religiously conservative areas, and in case of success can be modified to be applied as a sustainable health communication tool to similar situations in other conservative and underserved regions.