Introduction Online sexual health testing services may enable access to testing by different sectors of the population. An innovative online sexual health service designed to improve access to and availability of sexual health services in partnership with terrestrial services is commissioned in seven areas across England. This study compares use across commissioned areas.

Methods We used routinely collected testing data to analyse use of the service in different areas. We included cumulative data on use of the service since roll-out.

Results In areas outside London, fewer users had been to a clinic before (66.5%–73.1% vs 81.1%). Positivity rate was also generally higher outside London (6.8 – 11.0% vs 6.8%). The majority of users were asymptomatic, which is appropriate for the service. Within the London boroughs, the majority of users (51.8%) were in the 25–34 age bracket while in all other areas there was a higher proportion of younger users. In all areas, females used the service more than males. Use by ethnicity was related to local area demographics.

Discussion The online service increased access to STI testing in all commissioned areas and shows important differences in online service use in different geographical regions. This may reflect differences in unmet need and access to terrestrial services. Further work is needed to understand these differences.