AbstractBackgroundSexually Transmitted Diseases (STDs) are common and costly, impacting approximately one in five people annually. Reddit, the sixth most used internet site in the world, is a user-generated social media discussion platform that may be useful in monitoring discussion about STD symptoms and exposure.ObjectiveThis study sought to define and identify patterns and insights into STD related discussions on Reddit over the course of the COVID-19 pandemic.MethodsWe extracted posts from

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... eddit from March 2019 through July 2021. We used a machine learning text mining method, Latent Dirichlet Allocation (LDA), to conduct a text analysis to identify the most common topics discussed in the Reddit posts. We then used word clouds, qualitative topic labelling, and spline regression to characterize the content and distribution of topics observed.ResultsOur extraction resulted in 24,311 total posts. LDA Coding showed that with 8 topics for each time period we achieved high coherence values (pre-COVID=0.41, pre-vaccine=0.42; post-vaccine=0.44). While most topic categories remained the same over time, the relative proportion of topics changed and new topics emerged. Spline regression revealed some key terms had variability in the percentage of posts that coincided with COVID-19 pre- and post-periods, while others were uniform across the study periods.ConclusionsOur study's use of Reddit is a novel way to gain insights into STD symptoms experienced, potential exposures, testing decisions, common questions, and behavior patterns (e.g., during lock down periods). For example, reduction in STD screening may result in observed negative health outcomes due to missed cases, which also impacts onward transmission. As Reddit use is anonymous, users may discuss sensitive topics with greater detail, and more freely than in clinical encounters. Data from anonymous Reddit posts may be leveraged to enhance understanding of the distribution of disease and need for targeted outreach/screening programs. This study demonstrates Reddit has feasibility and utility to enhance understanding of sexual behaviors, STD experiences, and needed health engagement with the public.