Ben Goldacre, The Guardian, Saturday 27 March 2010
After the Mail’s definitive headline of last year “How using Facebook could raise your risk of cancer” (in the same week as a story about a radioactive paedophile, no less) comes a competitor. “Facebook spreads syphilis” was the front page headline in the Sun on Wednesday: “sex diseases soaring due to facebook romps”. The Mail was quick to follow, with “Facebook ‘sex encounters’ linked to rise in syphilis”, while the Telegraph had “Facebook ‘linked to rise in syphilis’: Facebook has been linked to a resurgence in the sexually-transmitted disease syphilis, according to health experts.” It even made the Star.
Where did these stories come from? A press release and quotes from NHS Tees, in which Prof Kelly, their Director of Public Health, described a rise in syphilis in his area, and explained that during contact tracing, some cases had mentioned having sex with people they met through the internet. No more. “Several of the people had met sexual partners through these sites,” he said: “social networking sites are making it easier for people to meet up for casual sex.” You can read his quotes online and decide how much responsibility Prof Kelly should take as the trigger for the story. The newspapers then bolted on a recent survey reporting that Sunderland has high use of Facebook and drew a more explicit link.
So firstly, is this link at all likely? Our supposed causal exposure is new, as Facebook opened to general users in 2008 2006. But national figures show a steady increase in STIs over the past 10 years, much more for syphilis than others, which could be due to all kinds of things (changing patterns in migration and men who have sex with men are often cited). There’s no sudden extra spike for the last few Facebook years.
And was there really a syphilis blip in NHS Tees? “There has been a four fold increase in the number of syphilis cases detected with more young women being affected,” said Prof Kelly. The numbers are small (from less than 10 to about 30) and turn out to be only for a subgroup: heterosexual people. As regular readers will know, the more you chop your data into smaller slices – by time period, by area, by behaviour group – the more likely you are to find what looks like a cluster in one of those subslices. I reckon theirs might be a true blip, but it would be nice see the overall syphilis figures for the same time period at least.
NHS Tees refuse. I ask for other STI’s, like chlamydia, in the same period (you’d expect them all to be increased, if it’s the websites). They say they don’t have that data yet. Fair enough. I ask for data on previous years, to look at the trend, and basically they were very unhelpful. They’ll only give me 2 years, although they have more, so I can’t see a trend, and they refuse to break it down by sexuality, so the figures are incomparable, then they refuse to give any more numbers, and simply ignore emails.
Does that tell you a wider story about who’s at fault here? It’s arguably fair enough for a Director of Public Health to mention that internet dates have emerged as a theme in their contact tracing interviews. But when the story gets out of hand, and it’s attributed to you, as DPH, that Facebook causes syphilis, then what should you do?
Compare this. The same story was also picked up in the Birmingham Mail: this time they had a 2000% increase in syphilis at a local clinic, being quoted by a Ms Hyland from Birmingham University. A Birmingham medical student blogger got in touch with Ms Hyland, who said she had nothing to do with this figure, the university press office swung into action, chased the story, announced the figures weren’t from them, and had the Birmingham Mail take down story while the paper investigated.
Many people seek excuses to dismiss sexual health advice, and there’s a wealth of misinformation on the topic. When you have the chance to tackle that misinformation – when you’ve become a part of it – you grab it with both hands. From NHS Tees & their DPH there was no follow up press release, no criticism of these nonsense stories, I asked what efforts they’d made to correct them, and again, they refused to answer. Meanwhile the idea that a British DPH was dumb enough to think Facebook caused syphilis continued to spread around the world, from Australia to India, through high-traffic websites like the HuffPo and Slashdot, CNN, and another two whole follow-ups in the Telegraph, much of which began to openly mock Prof Kelly, and much of which was perfectly avoidable.