MISH the Sexual Health Bot


Say hello to MISH! That stands for ‘Motivational Interviewing for Sexual Health’.

MISH is a text-based chatbot that uses motivational interviewing techniques to promote safe sexual behaviour. Through relational strategies, counselling techniques and other features, MISH is able to guide users through several short conversations in an autonomy-supportive manner to help them carry out specific safe sex behaviours.

In this project, MISH will address condom use in new, young couples, as well as pre-exposure prophylaxis (PrEP) use in couples at risk for HIV.


The foundation of MISH is motivational interviewing (MI). Therefore, MISH guides users through short conversations, each of which corresponds to an MI phase – Engage, Focus, Evoke and Plan.

For example, let’s consider condom use. After an initial interaction to break the ice (Engage), MISH first draws attention to the topic of condom use and elicits the interest in discussing it further (Focus). After this, MISH invites users to explore and name the reasons they can think of for incorporating condoms into their new sexual relationships (Evoke), eliciting the perceived importance of practicing consistent and safe condom use. Finally, users are instructed to select a condom use preparatory behaviour and devise a plan for carrying it out (Plan).

Throughout the interaction, the core principles of MI are implemented in a way that is currently feasible, with room for improvement in future prototypes. Importantly, as in a face-to-face MI session, the client is given the freedom to decide if they would like to move to the next session.

Future work! At the moment, we are testing MISH with single interactions with individual users and will soon extend our testing to long-term and dyadic interactions. Stay tuned.


MISH largely follows a pre-defined MI script devised by us, the researchers! However, there are controlled moments where we leverage models to select (or generate) appropriate responses to user input.

MISH is currently capable of:

  • Asking open questions to bring out users’ knowledge, thoughts, and motivations
  • “Understanding” (classifying) the users’ responses to open questions (e.g. why using condoms (doesn’t) make sense, reasons for using condoms, potential obstacles they might face)
  • Summarizing users’ responses across conversations back to the user to provide overviews
  • Reacting to users’ responses by selecting the most appropriate reflection through a retrieval model
  • Providing expert-approved sexual health information (with users’ permission) following the MI elicit-provide-elicit method


You can talk to our chatbots on https://lwt.cls.ru.nl/chat.

In order to talk to our bots;

  1. You need to create an account first. You can do this with a mock-up email address, without revealing your personal identity!
  2. Once you log in, MISH will greet you, which will show up on the left side of this page, under the title “Direct Messages”.
  3. Simply click on the chatbot name on the list to open the chat.
  4. Finally, just say “Hello” to it, and it will be with you in a second.
  5. Please read the Terms and Conditions and Privacy Statement sections on the website before talking to our chatbots


For more information, see our publication on this study:

Balaji, D., He, L., Giani, S., Bosse, T., Wiers, R., & de Bruijn, G. J. (2022). Effectiveness and acceptability of conversational agents for sexual health promotion: a systematic review and meta-analysis. In Sexual health19(5), 391-405.

Conference Presentations

  • Using counselling-inspired relational strategies to facilitate self-disclosure with a chatbot in a sensitive domain: A qualitative study. Accepted for presentation at the 73rd Annual International Communication Association Conference, 25-29 May 2023, Toronto, Canada.
  • Using counselling-inspired relational strategies to facilitate self-disclosure with a chatbot in a sensitive domain: A qualitative study. Accepted for presentation at Etmaal van de Communicatiewetenschap 2023, 2-3 February 2023, Enschede, Netherlands.
  • Conversational Agents for Sexual Health Promotion: A Systematic Review. European Conference for Health Communication, 4-5 November 2021, Online. Read more.
  • Introducing ‘Look Who’s Talking’: an interdisciplinary project for designing engaging and long-term chatbot interactions for health promotion. Etmaal van de Communicatiewetenschap 2021, 4-5 February 2021, Online. Read more.