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Young people who received texts from a messaging service promoting safe sex had higher rates of sexually transmitted infections than those who did not, a study has found.

Researchers from the London School of Hygiene and Tropical Medicine had set out to examine whether texting teens and young adults about safe sex would stop them from getting further infections.

The study, published in the BMJ, looked at two groups of more than 3,100 16 to 24-year-olds who had a previous infection of chlamydia, gonorrhoea, or "non-specific urethritis" - an infection of the urethra most commonly caused by an STI.

One group was signed up to the Safetxt project which aimed to reduce chlamydia and gonorrhoea reinfection by encouraging participants to follow their STI treatment properly, including informing partners about their own infection, promoting condom use, and encouraging participants to seek STI testing before unprotected sex with a new partner.

Participants receiving dozens of texts on the subject at varying intervals, tailored to gender and sexual orientation and recipients could ask for more information on specific topics.

The second group did not receive the texts, but had a monthly text checking their postal and email addresses were the same.

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Researchers found that 22.2% of those who received the Safetxts were re-infected with chlamydia or gonorrhoea, compared to just 20.3% in the other group.

The study authors wrote: "The Safetxt intervention did not reduce chlamydia and gonorrhoea reinfections at one year in people aged 16-24 years.

"More reinfections occurred in the Safetxt group.

"The results highlight the need for rigorous evaluation of health communication interventions."

Need for rigorous evaluation

The authors said the World Health Organisation (WHO) recommends the use of digital health communication for "strengthening health systems, including for sexual and reproductive health", provided that privacy and sensitivity concerns can be taken into consideration.

But the researchers said: "In light of our results, WHO should revise its endorsement of digital behaviour change communication for strengthening health systems, to specify which topics and content WHO endorses."

They concluded: "Safetxt did not reduce STIs. More reinfections occurred in the intervention group. Our results highlight the need for rigorous evaluation of health communication interventions.

"Future work could evaluate the effect of interventions promoting condom use and STI testing in those at risk but with a diagnosis of an STI.

"Further research should focus on how to reduce the stigma associated with STIs to benefit wellbeing, treatment, and precautionary behaviours for those with a diagnosis of an STI, without increasing the risk of infection."