A Blockchain Solution to Sexually Transmitted Infections in Online Dating Pt. II

In the previous article I outlined a problem and high-level solution to the sexually transmitted infections in online dating. Unsurprisingly, sexually transmitted infections contain all sort of social stigmas and remain a problem in both developed and developing nations. The issue of sexually transmitted infections is far worse for minorities and individuals of lower socioeconomic status.

In many ways, unfortunately, this makes sense. Poorer areas will likely have less access to medical services. Contraceptives can be harder to come by. And, in some areas, sexual education is almost non-existent (like America).

I won’t continue to delve into the problem and consequences of sexually transmitted infections because there are armies of really smart doctors and statisticians working on that.

Instead, this article is intended to expand upon the last article and delve into some of the potential solutions to the problems outlined in the previous article. I am actively working on building out the solution here and hope that this will spur a conversation that will improve the solution’s effectiveness and scaleability.

After all, it won’t work if only 10 people are using it.

The fundamental question in which this article builds upon is as follows:

With such ease of access and the semi-anonymous structure of many dating applications, how is it possible to trust another person’s word on their sexual health status? Is it possible to confidently know their status if the relationship is destined to be short lived?

This question is at the heart of any sexual encounter with another person that isn’t completely trusted. Beyond outright monogamy and a fully-trusting relationship, it is impossible to know with certainty the sexual health status of another human being — whether it be for a one-night stand or a continuous sexual relationship.

Fortunately for us, and beyond some nuanced infections (such as viral load in HIV, HSV-2, and others), sexually transmitted infections can be conceptualized in a relatively binary manner.

Put differently, a person either has a sexually transmitted infection or they don’t. While often asymptomatic in many people, a person can’t sort-of have Chlamydia (please correct me if I’m wrong here. I’m not a doctor by any means).

That is really good news because if that’s the case then it is entirely possible to quantify the status of individuals in a binary manner.

What’s amazing is that all of a sudden we can convert your sexual health status into a piece of data. And an important one at that.

But…

What would the world look like if we had instant, accurate, and transferable sexual health status? What if we could engage in sexual intercourse with another person and be certain that they are are free of all sexually transmitted infections?

In this case I certainty wish the world looked a little bit more like Ricky Gervais’s, “The Invention of Lying.” Instead, we live in a world where people will lie about their status or, more frequently, they just don’t know what their sexual health status is. That is a problem, and a multi-faceted one at that. Sex is full of social stigma — laying a cloud of complicated societal expectations around the discussion of sexuality, infection, and everything in between.

In my last article, I proposed that we remove the human trust element and, instead, replace it with trust in code and contracts.

But what do I mean by code and contracts?

Let me start with a definition of a blockchain and how it relates to us.

Borrowing from Preethi Kireddy’s article on Ethereum:

A blockchain is a “cryptographically secure transactional singleton machine with shared-state.” [1] That’s a mouthful, isn’t it? Let’s break it down.

“Cryptographically secure” means that the creation of digital currency is secured by complex mathematical algorithms that are obscenely hard to break. Think of a firewall of sorts. They make it nearly impossible to cheat the system (e.g. create fake transactions, erase transactions, etc.)

“Transactional singleton machine” means that there’s a single canonical instance of the machine responsible for all the transactions being created in the system. In other words, there’s a single global truth that everyone believes in.

“With shared-state” means that the state stored on this machine is shared and open to everyone.

Ethereum implements this blockchain paradigm.

Digging into that statement, let’s explore the idea behind the Transactional singleton machine and then extend it. Money is a good example of this. Suppose there are two people in the world — Adam and Eve. Adam has 5 dollars (and on the first day America was born apparently) and Eve has 5 dollars. The state of the world is that Adam has 5 and Eve has 5. Eve gives Adam 4 dollars. There’s a state change. Adam now has 9 and Eve has 1.

Now the extension part. If it is possible to measure the state of value is it possible to extend this to other data types? Ethereum is doing that. And so much, astronomically much, more than that.

Now what if we could model sexual health status as a transactional singleton machine with shared state? Put differently, what if we could have a shared truth of each and everyone one of our sexual health statuses’ that could, in turn, be freely traded with one another prior to intercourse?

That’s what this project aims to achieve.

Okay, great. On the other hand I wouldn’t want some of my most sensitive medical information posted all over the internet.To address some of these issues, let’s start with some design principles:

1. Sensitive medical data should only be shared with the the individuals in which it is intended to be shared with.

2. Medical information should be owned and ultimately controlled by one-individual and should avoid being stored in a centralized location. If I were a hacker I can’t think of just about anything more valuable.

3. It should be possible to abstract away the unnecessary data-elements that aren’t directly related to the user’s intent.

4. Medical information should be shareable in a manner that is instant and independent of government intervention.

5. The medical information (in the case of a positive STD/STI result) be audit-able without giving out the identify the user.

With those principles in mind, if it were possible to create verifiable status that is both transferable and private, then all of a sudden trust is no longer a sociological issue and consent is now a provable piece of data.

I am proposing that it is possible to create transferable sexual health status on the Ethereum blockchain. This can be done (at a high-level) with the following process:

Register a user → User goes to a sexual health clinic and gets their status verified → The now verified status is encoded and tokenized so it can be used among users to verify status → The now verified user trades their unique token (ERC 720) between themselves knowing that the other’s medical information has also been verified.

With privacy and verification of the accuracy of the data as the top priorities — EY is working on this problem with a solution they call Nightfall — the next problem that seems apparent to me is the problem of the user-base.

A solution to a problem that involves everyone can only be effective if the user-base is large and diverse. In other words, the success of verifiable sexual health in a world of sexually active people only works if many sexually active people verify their status. It’s the classic network effect problem.

Assuming the verification and privacy challenges can be solved (I’m optimistic), the question becomes:

How do we get as many users to verify their status as possible?

Is there even a consumer demand for such a solution?

After all, why hasn’t someone already built and scaled this solution if the WHO so clearly says it’s a problem?

Going forward, and to dice these problems out into smaller bites, let’s start with the ease of integration. Getting tested is difficult enough. So it follows that every additional difficulty to integrate the results into a tradeable token should therefore require as few steps as possible. It should also be able to reach the maximum number of users through the least amount of effort.

In that way this solution can be implemented as:

1. A plug-in placed as a feature within the existing dating applications around the world (piggy-bagging on existing infrastructure).

2. A stand-alone dating application that is targeted at customers that live a lifestyle involving a high number of sexual partners (high-value customers).

3. A version in which allows users to exchange status just prior to having intercourse in a socially fluid manner.

The second problem is the problem of demand. Do people actually care about avoiding sexually transmitted infections and are they willing to use a solution that requires the additional steps to do so? That is another problem to solve altogether. If you’re passionate about solving a problem that affects well, everyone, drop me a line and let’s talk.

Until then, cue exit music