Introduction In 2016, The British Association of Sexual Health and HIV (BASHH) expressed concern over the use of medications purchased online to treat Sexually Transmitted Infections (STIs) ‘without full examination and specialist input’. Few studies have investigated the extent of this practice; our service wanted to establish availability of treatment and determine if patients are managed according to BASHH guidelines.

Methods A prospective internet search was performed using the keywords ‘STI treatment online’. UK based internet pharmacies offering treatment for Gonorrhoea, Chlamydia, Herpes and Trichomonas were included in the study.

Results 30 websites were identified; 5 were excluded. 25(100%) required assessment by a Doctor/Pharmacist Prescriber. 5(20%) offered Gonorrhoea treatment; of these, only one offered Ceftriaxone 500mg/Azithromycin 1 gram and no websites made customers aware that Gonorrhoea cultures were required prior to treatment.

23(92%) websites offered Chlamydia treatment as Azithromycin 1 gram stat and/or Doxycycline 100mg twice daily for seven days however, none of the websites asked whether treatment was required for patients at risk of rectal Chlamydia or Lymphogranuloma Venereum. Patients seeking Chlamydia treatment were advised to abstain from sex on 16(64%) websites and partner notification was advised on 18(72%) websites.

22 (88%) websites offered treatment for Herpes. 6(27%) required no photographic/laboratory diagnosis of Herpes before purchase. 15(68%) did not discuss partner disclosure of a Herpes diagnosis.

Discussion Online pharmacies have established a niche market for patients who are reluctant to access clinic based healthcare. Our results show variable adherence to BASHH guidelines which may compromise health outcomes for patients seeking internet based therapy.