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Darkly humorous e-cards that allow people diagnosed with STDs to anonymously alert their sexual partners are helping fight the spread of infections, according to a new report.

The email postcards, which can be personalised by type of infection, are sent by men and women who may otherwise be too embarrassed to break the bad news to former lovers.

More than 30,000 Americans have used the service, which was set up in San Francisco in 2004 but has now been rolled out to cities across the US.

Many of the e-cards contain visual puns to catch the attention of the recipient.

Versions currently available on the inSPOT.org website include one with the message “I got screwed while screwing, you might have too,” next to a picture of a screw, and another featuring a stretch of twine with the tag “Sometimes there are strings attached”.

Dr Jeffrey Klausner, of the San Francisco department of health, said that the service had proved an “innovative and effective way” of spreading awareness of possible infections.

"We know inSPOT works," he told the Washington Post. "I see patients, they come in and say they've been notified, and their contact is through inSPOT."

People diagnosed with an STD such as syphilis, gonorrhea, HIV can visit the site and enter the email addresses of everyone they have slept with since they were infected. They then select their home town, give details of the nature of their infection, and decide which card they want to send.

Their former partners then receive an email with the subject line, "E-card from a concerned friend re: your health via inSPOT", which contains medical information about the infection and details of their nearest testing clinics.

Although there have been a handful of complaints about misuse of the service, a new report by California sexual health officials published on the Public Library of Science website said that it had the potential to become a "national and international resource".

Sexual disease e-cards break news of infection with humour - Telegraph