Utilizing the internet to test for sexually transmitted infections: results of a survey and accuracy testing
- Sherria L Owens1,
- Nick Arora2,
- Nicole Quinn2,
- Rosanna W. Peeling3,
- King K Holmes4,
- Charlotte A. Gaydos2,*
- 1 Morgan State University, United States;
- 2 Johns Hopkins University, United States;
- 3 World Health Organization, United States;
- 4 University of Washington, Switzerland
- Correspondence to: Charlotte A. Gaydos, Div of Infectious Diseases, Johns Hopkins University, Division of Infectious Diseases, Johns Hopkins University, 530 Rangos Bldg., 855 North Wolfe St., Baltimore, MD 21205, Baltimore, 21205, United States; cgaydos{at}jhmi.edu
- Received 10 April 2009
- Accepted 8 August 2009
- Published Online First 22 October 2009
Abstract
Background: Searching the Internet for information about sexually transmitted infections (STIs) is common. Our goal 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, we collected information from the sites about STI testing services, costs, and types of tests offered, and evaluated tests for accuracy. We investigated “business” functions regarding consent, and return of results. Contact attempts were made by phone, email 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 gonorrhea.
Results: We identified 27 national/international Internet sites offering STI self-collection kits and services. Tests were available for gonorrhea, 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/email to all of the sites, four responded, two with the survey. Six websites appeared invalid based on non-deliverable emails and returned letters. The remainder did not respond. Test results were obtained from 5/7 ordered kits. Two websites 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 test having poor accuracy and mail-in specimens demonstrating high accuracy.
