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O08.4 Online Access to Home STI Specimen Collection and E-Prescriptions Linked to Public Health - is a Comparative Effectiveness Trial Feasible?
  1. F Spielberg1,
  2. V Levy2,
  3. I Kapur1,
  4. S Lensing3,
  5. N Acevedo4,
  6. L Venkatasubramanian4,
  7. C Leivermann5,
  8. S Philip6,
  9. N Padian7,
  10. C Gaydos8
  1. 1George Washington University, Washington, DC, United States
  2. 2San Mateo County Health System, Stanford University, San Mateo, CA, United States
  3. 3University of Arkansas for Medical Sciences, Little Rock, AR, United States
  4. 4FHI360, Durham, NC, United States
  5. 5Contra Costa Health Services Department, Martinez, CA, United States
  6. 6Department of Public Health, San Francisco, San Francisco, CA, United States
  7. 7University of California, Berkeley, Berkeley, CA, United States
  8. 8Johns Hopkins University, Baltimore, MD, United States


Background Online STI testing and treatment may improve access at lower cost and with higher acceptability than clinic-based services.

Methods We conducted a demonstration (non-significant-risk medical device) study of an online system for STI education, vaginal specimen collection for chlamydia, gonorrhoea, and trichomonas testing, treatment, and partner notification, in collaboration with 4 San Francisco Bay area health departments. English and Spanish speaking women (18–30 yr) were recruited over 3 months through various methods.

Results The website had 6,855 hits with a click through rate of 6.6%(450). Of 256 deemed eligible, 85%(217) enrolled. Among these, 54% (117) had not seen a clinician in the past year and 87%(142) had not had an STI test since last unprotected sex. Among those mailed a kit (213), 67% (143) returned the kit. Of these, 80% (115) of participants accessed test results online the same day results were posted, within 2 days (86%, 122) or by study end (92%, 131). STI prevalence was 5.6% (chlamydia and trichomonas). All STI infected participants received treatment either the same day (75%,6/8) at a pharmacy or within 7 days at a clinic (25%, 2/8). Internet recruitment reached the highest number of participants (100/217, 46%), while advertising on subways reached the highest number of positives (5/8, 63%). Of 106 participants completing follow-up surveys, 98% (104) indicated the site was easy to use and 98% (104) would recommend the project to a friend. No negative outcomes were reported. If participating in a future trial, 94% (100) would prefer an online system over clinic-based care.

Conclusions An online system for STI testing and treatment appears feasible, and highly acceptable to participants. We recommend a future comparative effectiveness trial to determine whether an online system can increase testing and treatment of STI infections at lower cost and with higher acceptability than clinic-based care.

  • e-prescription
  • internet
  • STI

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