CATIE News

24 October 2019 

Positive trends for Internet-based testing for sexually transmitted infections

  • Researchers evaluated an online testing service for sexually transmitted infections
  • The B.C. program offers direct access to testing through online lab requisitions
  • Users of Internet-based testing were 22% more likely to use the service again

Getting screened for sexually transmitted infections (STIs) usually involves a visit to a clinic so that specimens can be obtained. A follow-up visit may be necessary to receive test results and, if necessary, treatment. As many people lead busy lives, they can encounter issues that hamper easy access to such services, such as travel time and interruption of work schedules. These issues, along with time spent in a waiting room, can discourage future visits.

According to the British Columbia Centre for Disease Control (BCCDC), “increasing access to testing for sexually transmitted and blood-borne infections [STBBIs; for the purposes of this article we will use the abbreviation STIs] is fundamental for preventing these infections.” The Centre notes that STI screening and treatment have benefits for individuals and for society. For instance, “individuals can get timely diagnosis and treatment to prevent complications.” Society benefits because people who are diagnosed and treated for STIs have better health, are educated about preventing STIs and, thanks to treatment, do not pass on the infection.

Scientists at the BCCDC noted that some sexually active gay, bisexual and other men who have sex with men (MSM) have relatively high rates of STIs. Increasing opportunities for screening for these infections is important for the health of this population.

Online access to STI testing

A team of scientists at the BCCDC conducted a study comparing repeat testing (getting a test more than 30 days after the last one) between people who used an Internet-based STI testing service called Get Checked Online (GCO) and people who went to STI clinics in Vancouver. The scientists assessed data from more than 19,000 people who sought testing for the following:

  • chlamydia
  • gonorrhea
  • HIV
  • hepatitis C virus

According to an article to be published in the medical journal Sexually Transmitted Infections, the scientists found that people who used the online testing service were more likely to have repeated STI screening (22%) compared to people who went to clinics. Internet-based testing services have the potential to increase the frequency of STI screening and therefore help people with STIs get diagnosed and treated early.

Study details

The scientists used data collected from 19,497 people distributed as follows:

  • 1,093 people from the Internet-based testing service GCO
  • 18,404 people from STI clinics

About 40% of participants were MSM.

How Internet-based STI testing works

The scientists’ explanation for how Get Checked Online works is as follows:

“Individuals visiting the GCO website create an account using their email address, complete a risk assessment, create a laboratory form to take to a local specimen collection site, provide specimens, and obtain results online (if negative) or by phone (if positive). Individuals reporting symptoms or a partner with an STI are recommended to go to a clinic but may proceed [with further use of the GCO site].”

Some of the testing involves the use of self-collected throat and rectal swabs. In cases where blood is required, users can go to a designated lab.

The scientists stated that “GCO was developed as an extension of the provincial STI clinic at the BCCDC, mirroring its low-barrier clinic practice including no fees, similar test recommendations and consent processes, and no verification of client identity. Tests are performed using a system-generated unique alphanumeric code instead of first and last name (same code used each time a user tests through GCO). GCO also includes automated email testing reminders…”

The scientists analysed data collected between September 2014 and February 2017.

Results

Analysis found that people who used Internet-based testing services were 22% more likely to use the service again in the future. According to the scientists, this finding supports the idea “that Internet-based STI testing services can lead to increases in testing frequency and are complementary to face-to-face clinical services.”

Bear in mind

The study was observational in design and so its conclusions are not definitive. However, the scientists undertook rigorous additional statistical tests to confirm the validity of their findings. Furthermore, randomized clinical trials in Australia and France have found that self-testing for chlamydia increases repeat testing, at least in the short term.

Previous surveys have found that GCO clients appreciate the convenience and relative privacy associated with Internet-based STI screening services. The scientists stated that this previous research had found that GCO clients appreciated the reminder emails and other information that helped them understand their personal and “ongoing risk” for STIs.

For the future

The present study adds to the documentation supporting the continuation of online-based testing services. Similar studies could be conducted in other parts of Canada to assess the impact of Internet-based STI testing services for MSM and other populations.

Resource:

Get checked online - BCCDC

—Sean R. Hosein

REFERENCE:

Gilbert M, Salway T, Haag D, et al. A cohort study comparing rate of repeat testing for sexually transmitted and blood-borne infections between clients of an Internet-based testing programme and of sexually transmitted infection clinics in Vancouver, Canada. Sexually Transmitted Infections. 2019; in press.