When a person finds out he or she has an STD and wants to inform past sexual partners they may have been infected, the conversation can be awkward. But the Chicago Department of Public Health has partnered with a website called InSpot to alleviate some of that discomfort with STD notification e-cards.

InSpot was originally created in California in 2004 as a response to an increase in STDs among gay men, said Dr. William Wong of the Chicago Department of Public Health. Now, the e-cards have been utilized in 11 cities and 10 states across the U.S. , and Chicago is seeing a large response.

“Since 2006, we have seen an increase in the number of people accessing cards and the number of people sending cards,” Wong said.

Chicago started using InSpot in 2006, and 868 cards were sent throughout the city the first year. In 2008, 3,550 e-cards were sent.

Wong said that the city expects 2009 numbers to be even higher because more people are learning about the site through their friends and doctors.

Cook County is a “high morbidity area” for sexually transmitted infections, Wong said.

“In terms of Cook County among all U.S. counties, it ranks first for the total number of gonorrhea cases, No. 2 for Chlamydia, and No. 4 for primary and secondary syphilis,” Wong said. “Having an effective tool like InSpot can really help address high rates of STDs in the city and county.”

The rules of InSpot are simple. When a person finds out about their diagnosis, they visit the website and pick an e-card to send to their sexual partners via e-mail. There are six e-cards for the city of Chicago, and they were chosen out of a large database available from InSpot.

One e-card reads, “I got screwed while screwing, you might have, too.” Another says, “It’s not what you brought to the party, it’s what you left with.”

The sender picks their e-card and can send it confidentially or anonymously to the recipient. The sender does not have to give their e-mail address if they do not want to be identified, but the sender can opt to write a note to go along with the e-card if they choose.

The e-cards are picked carefully with respect to the people using them, said Deb Levine, executive director of the Internet Sexuality Information Services.

The choice of e-cards depends on location and the types of disease prevalent, Levine said.

When picking an e-card, the STD that was diagnosed must be provided and, as of right now, there is only one e-card available for HIV. In a different section of the site, the HIV e-card has links to a 24-hour hotline and possible counseling services. All the e-cards have a link back to the InSpot website where there is more information on each STD and clinics in Chicago where they can get tested.

InSpot has sent out about 40,000 e-cards nationwide since 2004, and issues of abuse have been minimal, according to Wong. InSpot is free and users do not need to give their personal information and anybody can access the website.

“InSpot was developed as a public health response to rising rates of STDs,” Levine said. “There are times, of course, when people send e-cards to other people either to let them know about the service or potentially using it not for the site’s intended use.”

If InSpot is made aware of false claims, they send e-mails out that explain the “public health nature” of the site and also use the e-mail as a way to let people know they should still be getting tested for STDs if they are sexually active, Levine said.

The number of reported cases of abuse so far is less than 10, Wong said.

The website Nookist.com, which is included in the resource list for InSpot users, has a mission of public health awareness similar to InSpot’s and is part of an online fight against STD spreading.

Nookist is like a little black book for the Internet age. It gives users a percentage, based on their sexual activity, of how likely they are to get an STD.

Robert John Ianuale is the president of Nookist and came up with a method of determining what he calls a person’s “venereal disease notification.”

“It can analyze your account and give you a probability and a percentage of obtaining several sexually transmitted diseases,” Ianuale said.

The formula also provides a comparison of the user’s results compared to other users and the national average.

Ianuale presented his idea at a sex technology conference in 2008 that was run by InSpot. The sites are geared at a younger, Internet savvy audience who, according to the Center for Disease Control’s Annual STD Surveillance Report, are most at risk of acquiring an STD or infection.