Let's chat about sex, baby! Leveraging chatbots for sexual health promotion

Sexually transmitted infections remain a major concern among youth, especially new couples who often stop using condoms early. This dissertation explores how conversational agents can support STI prevention by facilitating sexual health discussions. It emphasizes user-centered, qualitative methods to design and evaluate chatbots for individuals and couples.
Towards improved CAs that can engage new, young couples through interactions about condom use for STI prevention, this dissertation takes a progressive approach to design, and assess the user acceptance of, two conversational agents: Mish (for individual use), and MishSync (for couple use). Specifically, this dissertation provides an overview of sexual health CAs and identifies user acceptance factors relevant for this context (Chapter 2), after which Mish (Chapter 3) and MishSync (Chapters 4 and 5) are designed and evaluated (on the basis of the identified user acceptance factors) through interviews (see Table 1 for an overview of Mish and MishSync).
This research sheds light on key factors influencing user acceptance of sexual health chatbots, and highlights the role of machine-specific schemas in shaping user perceptions of chatbot interactions. Findings reveal that motivational interviewing can be successfully adapted for a chatbot-based sexual health intervention, fostering comfort and self-disclosure. Moreover, the user-centered design approach demonstrated that couples-based CAs are well-received but require distinct considerations, particularly regarding trust-building and partner dynamics. While CAs show promise for engaging young people in sexual health discussions, future research is needed to refine human-chatbot interactions for greater real-world adoption.