Privacy and Safety Experiences and Concerns of U.S. Women Using Generative AI for Seeking Sexual and Reproductive Health Information

Users increasingly rely on consumer-facing generative AI (GenAI) for tasks ranging from everyday needs to sensitive use cases. Yet, it remains unclear whether and how existing security and privacy (S&P) communications in GenAI tools shape users' adoption decisions and experiences. Understanding how users seek, interpret, and evaluate S&P information is critical for designing usable transparency that users can trust and act on. We conducted semi-structured interviews and design sessions with 21 U.S. GenAI users. Our findings suggest that available S&P information rarely drove initial adoption in practice, as participants often perceived it as incomplete, ineffective, or not credible. Instead, they relied on rough proxies (e.g., popularity) to infer S&P practices. After adoption, S&P uncertainty constrained participants' willingness to use GenAI tools, especially for high-stakes purposes, and, in some cases, contributed to discontinued use. Participants therefore called for transparency that supports decisions and actions through trustworthy information (e.g., independent evaluations) and usable interfaces (e.g., on-demand disclosure). We categorize participants' desired design practices into five dimensions to facilitate systematic future investigation into best practices. We conclude with recommendations for researchers, designers, and policymakers to improve S&P transparency in consumer-facing GenAI.

People increasingly bring their health questions to ChatGPT, yet safety evaluations of LLM health advice rest almost entirely on clinician-authored vignettes, synthetic prompts, or simulated user profiles. The gap is widest for the Global South, where concerns about demographic bias and unsafe recommendations are well documented but have never been tested on real usage. We present, to our knowledge, the first demographically grounded safety evaluation of real-world health conversations with ChatGPT. From a consent-based data-donation corpus of 202,590 conversations from 1,252 users in India, Nigeria, Brazil, and Pakistan (December 2022 to February 2026), each linked to self-reported age and gender, we identify 15,555 health conversations, classify their health intent using an LLM classifier adapted from an established taxonomy, and score response safety under both a context-blind and a user-context-aware rubric. Roughly one in five health conversations receives a high-risk rating. Risk concentrates in symptom and condition queries and recurs through identifiable failure modes: unsafe medication or dosage guidance, harmful self-diagnosis, missing safety warnings, encouraging over-reliance on the model, and failure to refer users to professionals. Supplying the user's own accumulated context raises the high-risk share by 13-17 percentage points, and about one in four conversations rated safe in isolation turns out to be unsafe for the specific person asking. Safety evaluations built on synthetic cases are likely to miss these harms.

AI chatbots are increasingly used for answering health-related questions. This study examines the role of topic type discussed with an AI chatbot and individual characteristics on perceived benefits and risks, intention to use an AI chatbot, and willingness to self-disclose health information. We conducted an online experiment with a 2 (topic type: physical versus psychological, between-subjects) x 2 (topic sensitivity: low versus high, within-subjects) mixed design among a Dutch representative sample (N = 1,388). Results showed that perceived benefits were positively associated with intention and willingness to self-disclose, while perceived risks were negatively associated. Moreover, participants reported higher usage intentions for low-sensitive topics compared to high-sensitive topics. Furthermore, perceptions, intention, and willingness to self-disclose varied by individual characteristics. Overall, our findings suggest that intentions to use AI chatbots and self-disclosure of health-related information are primarily related to perceived benefits and risks and to personal characteristics rather than to topic type.