Exploring Electronic Personal Health Record Services As Sexual Health Discussion Tools: A Mixed-Methods Study Among Young Black Adults

Background:  Young Black adults continue to share a largely disproportionate burden of HIV/STD rates compared to couterparts in other racial groups. The Electronic Sexual Health Information Notification and Education (eSHINE) Study is a mixed-methods study among students 18-25 years old at an urban university exploring perceptions on facilitating HIV/STD risk conversations with partners using electronic personal health records (PHRs) or patient portals. 

Methods: Iterative focus-group and individual interview sessions were conducted using a convenience sample of 35 students for extracting themes and codes on incorporating PHRs into contextualized risk discussion practices. An online survey instrument was developed and administered to a sample of 354 students for measuring the distribution of emergent qualitative perceptions. Stepwise logistic procedure identified predictors of likely PHR discussion adoption.  

Results:  Approximately 74.9% of participants were previously unaware of PHR services. PHRs were perceived to positively impact three aspects of risk discussions: (1) awareness and valuation, (2) ability, and (3) assurance. Approximately 62.8% of survey respondents reporting no risk discussion practices and 46.5% with inconsistent risk discussion practices believe PHR accessibility personally enables healthy risk communication practices with partners (OR=4.90; p=0.022 and OR=2.56; p=0.133). Intentional beliefs for receiving electronic HIV/STD results (OR=8.98; p<0.001), beliefs that PHRs improve self-efficacy for facilitating initial and check-in discussions with partners (OR=2.09; p=0.037 and OR=4.00; p=0.003), and device memory space concerns (OR=0.41; p =0.008) were significant predictors of likely adoption of PHRs in partner risk discussions.

Conclusions:  Triangulated findings suggest that young Black adults perceive PHRs as useful discussion tools and consider healthcare providers as a primary gateway for accessing comprehensive patient portal services. PHR awareness and access must be addressed in order to further explore its effectiveness in improving partner communication and disease prevention. Targeted strategies are needed for improving awareness and access to culturally appropriate patient portal services across at-risk populations.