Generative AI Chatbots as Digital Adjuncts for Sexual Health Information After Prostate Cancer in Men Who Have Sex...

Area of Science:

• Digital Health
• Artificial Intelligence in Healthcare
• Sexual Health Research

Background:

• Sexual health issues post-prostate cancer treatment are common but often inadequately addressed, especially for men who have sex with men (MSM).
• MSM face unique barriers including heteronormative assumptions and lack of tailored information, impacting their engagement with healthcare.
• Generative artificial intelligence (GenAI) chatbots are increasingly used by patients for sensitive health information, prompting investigation into their utility and framing.

Purpose of the Study:

• To describe and compare GenAI chatbot responses to sexual health questions following prostate cancer treatment, focusing on the needs of gay men.
• To interpret these chatbot responses using netnographic and actor-network theory frameworks.

Main Methods:

• A qualitative exploratory study employing auto-netnography with four leading GenAI chatbots (ChatGPT, Claude, Copilot, Gemini).
• Standardized prompts were used, simulating a "mock patient" seeking information on post-prostate cancer sexual health and sexual minority-specific issues.
• Chatbot outputs were analyzed qualitatively, focusing on interactional framing, emotional tone, specificity, and performative features, excluding clinical effectiveness assessment.

Main Results:

• GenAI chatbot responses generally used inclusive language for sexual health concerns, varying in emotional tone, specificity, and cultural sensitivity.
• Interactional features included framing of clinical information, dialogue encouragement, self-care advice, and explicit discussion of same-sex practices; contextual inaccuracies were noted.
• Responses were categorized into four interactional styles: structured overview, rational clarity, compassionate perspective, and compassionate precision.

Conclusions:

• GenAI chatbots can provide supportive, culturally sensitive, and LGBTQI+-inclusive communication for sexual health interactions, acting as digital adjuncts.
• While not replacing professional care, these AI systems can complement clinical practice by facilitating reflection and access to sensitive information.
• Care-like meanings can emerge from user-AI interactions, highlighting the sociomaterial nature of digital health support rather than generalized clinical reliability.