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And while Neat Club does warn users that its required tests every four months don't guarantee safety, Wyand said, the implicit suggestion that a user's status has been confirmed one way or the other poses a problem.""Whether it's with this app or just by going into your doctor, you’re not going to be tested for every sexually transmitted illness," he said.Both Shah and the app's online presence stress that Neat Club can't guarantee sex safe between its users, of course.But Shah said the added layer of caution can help users who practice safe sex to find added protection in a country where, as Neat Club's website observes, there are 20 million new STI diagnoses each year, one in six adults reportedly has genital herpes, and closer to two-thirds have the oral variety--in both cases, mostly asymptomatically."According to Shah's research and "crowd-sourced" input from doctors, the most common reasons for STI infection are improper or failed use of barriers (like having a condom break), oral sex or kissing, one or more partners not having been tested, one or more partners lying about their status, and recent infection that hasn't shown up on tests.  With the app, Shah hopes to address at least some of those issues, and bring awareness to others, while giving users a greater sense of control over their sexual health."Regardless of how much I trust that person, I’d like to have verified information," she said.

And when infections have cleared up, those indicators go away again, Shah said, which underscores the fact that sexual health can change, and needs ongoing maintenance.In doing so, it raises a range of questions and concerns far too vast for any one app (or app reviewer) to settle alone.It also provides an opportunity to consider the often insular and high-risk path that startup culture, as a whole, has chosen to follow so far--and whether it's finally time to change course.In terms of getting people to open up to their partners about sexual health, he added, "The online aspect may make it less daunting for some people, but at some point you need to have real-world conversations.", and former head of STD prevention for Public Health Seattle & King County "trailblazer" in the field,  Neat Club's testing requirements would also impose an undue burden on users by making them submit to (and likely pay for) a number of tests that are unnecessary and, in some cases, famously unreliable.For example, while testing for herpes simplex virus (HSV) 2 is reasonable, testing for HSV 1 is "a bad idea," Handsfield said.

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