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Utilising the internet to test for sexually transmitted infections: results of a survey and accuracy testing
  1. Sherria L Owens1,
  2. Nick Arora2,
  3. Nicole Quinn3,
  4. Rosanna W Peeling4,
  5. King K Holmes5,
  6. Charlotte A Gaydos3
  1. 1Morgan State University, School of Community Health and Policy, Baltimore, Maryland, USA
  2. 2Johns Hopkins University, Homewood Campus, Baltimore, Maryland, USA
  3. 3Johns Hopkins University, Division of Infectious Diseases, Baltimore, Maryland, USA
  4. 4The Sexually Transmitted Diseases Diagnostics Initiative, World Health Organization, Geneva, Switzerland
  5. 5University of Washington, Departments of Global Health and Medicine, Seattle, Washington, USA
  1. Correspondence to Dr Charlotte A Gaydos, Johns Hopkins University, Division of Infectious Diseases, International STD Laboratory, 530 Rangos Building, 855 North Wolfe Street, Baltimore, MD 21205, USA; cgaydos{at}jhmi.edu

Abstract

Background Searching the internet for information about sexually transmitted infections (STI) is common. The goal of the study was to discover which internet sites offer STI tests and obtain information about the services and their validity.

Methods Using internet web-based search engines, information was collected from the sites about STI testing services, costs and types of tests offered, and tests were evaluated for accuracy. ‘Business’ functions regarding consent and return of results were investigated. Contact attempts were made by phone, e-mail or ‘contact us’ links and by mail. Test kits were ordered from six commercial internet sites and one public health site. Their accuracy was evaluated for chlamydia and gonorrhoea.

Results The study identified 27 national/international internet sites offering STI self-collection kits and services. Tests were available for gonorrhoea, syphilis, chlamydia, HIV, herpes, hepatitis viruses, trichomonas, mycoplasma and ‘gardnerella’. All attempts to administer the survey yielded unsatisfactory results. After sending the survey by mail/e-mail to all the sites, four responded, two with the survey. Six websites appeared invalid based on non-deliverable e-mails and returned letters. The remainder did not respond. Test results were obtained from five of seven ordered kits. Two websites who were sent mocked urine specimens never provided results. The two ‘perform-it-yourself’ kits yielded false-negative results. Two mail-in urine specimens yielded correct positive results. The public health site kit yielded correct positive results.

Conclusions The internet STI testing sites were difficult to contact and demonstrated unwillingness to answer consumer-specific questions. Test accuracy varied, with home tests having poor accuracy and mail-in specimens demonstrating high accuracy.

  • Chlamydia trachomatis
  • diagnosis
  • gonorrhoea
  • internet
  • internet testing self-sampling for STI testing
  • outreach services
  • public health
  • sexually transmitted infections
  • STI testing services

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Footnotes

  • Competing interests CAG is the founder of one of the web sites reviewed: http://www.iwantthekit.org.

  • Ethics approval This study was conducted with the approval of the rated as exempt for consent by Johns Hopkins Institutional Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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