Online service boosts uptake of STI testing

More people test for STIs when they can do so via online services

People are more inclined to test when they can do so discretely at their own home. Photo: Shutterstock

People are more inclined to test when they can do so discretely at their own home. Photo: Shutterstock

People are more likely to be tested for sexually transmitted infection (STI) when the test is offered online compared to in a clinic, new findings show.

“Providing the option of an online STI testing service nearly doubles uptake of STI testing across all groups, including groups at higher risk of having a STI,” Dr. Caroline Free of the London School of Hygiene & Tropical Medicine and Dr. Paula Baraitser of King’s College London, who worked on the study, told Reuters Health in a joint email. The findings were published online December 27 in PLoS Medicine.

In e-STI testing, a person orders a test kit, collects and submits a sample, and receives results by SMS, text or telephone. This approach may improve STI testing coverage, which the researchers note is “suboptimal” in the U.K.

To investigate, they enrolled 2,072 men and women 16 to 30 years old who had at least one sexual partner in the past year and were willing to take an STI test. Study participants were randomly assigned to received a text message with a Web link to the online testing and results service, SH:24, or a link with contact information for seven local sexual health clinics.

At six weeks, half of the SH:24 group had undergone STI testing, versus 26.6% of the control group (relative risk, 1.87; P<0.001). STIs were diagnosed in 2.8% of the e-STI testing group and 1.4% of the control group (RR, 2.10; P=0.079), and treated in 1.1% and 0.7%, respectively (RR, 1.72; P=0.231).

Time to test was 28.8 days for the intervention group, significantly less than the 36.5 days for the control group, but there were no significant differences between the groups in time to treatment (83.2 vs. 83.5 days).

The researchers are now looking at whether e-treatment or postal treatment can improve STI-treatment rates.

“The new model that we are currently investigating is that the user completes a medical history online, this is reviewed by a specialist doctor who signs the prescription. This is then dispensed by an online pharmacy that sends the medication direct to the user’s address,” Dr. Free and Dr. Baraitser said.

They are also looking at the cost-effectiveness of SH:24 after implementation, and evaluating the feasibility and safety of providing contraception through an online service. Nevertheless, the researchers note, face-to-face care is still important for some patients.

“Although everyone in the intervention group was offered the online service some people chose to use face-to-face services,” Dr. Free and Dr. Baraitser said. “We think that the future is services that offer both online and clinic-based services with users able to move seamlessly between them. We recommend joint commissioning of online and face-to-face services to ensure users are able to move from one service to another according to their health care needs.”

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