Objectives Online services for self-sampling at home could improve access to STI testing; however, little is known about those using this new modality of care. This study describes the characteristics of users of online services and compares them with users of clinic services.
Methods We conducted a cross-sectional analysis of routinely collected data on STI testing activity from online and clinic sexual health services in Lambeth and Southwark between 1January 2016 and 31March 2016. Activity was included for chlamydia, gonorrhoea, HIV and syphilis testing for residents of the boroughs aged 16 years and older. Logistic regression models were used to explore potential associations between type of service use with age group, gender, ethnic group, sexual orientation, positivity and Index of Multiple Deprivation (IMD) quintiles. We used the same methods to explore potential associations between return of complete samples for testing with age group, gender, ethnic group, sexual orientation and IMD quintiles among online users.
Results 6456 STI tests were carried out by residents in the boroughs. Of these, 3582 (55.5%) were performed using clinic services and 2874 (44.5%) using the online service. In multivariate analysis, online users were more likely than clinic users to be aged between 20 and 30 years, female, white British, homosexual or bisexual, test negative for chlamydia or gonorrhoea and live in less deprived areas. Of the individuals that ordered a kit from the online service, 72.5% returned sufficient samples. In multivariate analysis, returners were more likely than non-returners to be aged >20 years and white British.
Conclusion Nearly half (44.5%) of all basic STI testing was done online, although the characteristics of users of clinic and online services differed and positivity rates for those using the online service for testing were lower. Clinics remain an important point of access for some groups.
- epidemiology (general)
- sexual health
- health serv research
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Handling editor Jackie A Cassell
Contributors SB, PB and CF conceived the study. SB, PB, CF and IB contributed to the study design, literature search, data management, data analysis, data interpretation and writing of the manuscript. PB, CF and IB are co-supervisors of SB. KJL contributed to the data management, data interpretation and writing of the manuscript. KMET contributed to the data management and writing of the manuscript. SB and PB had full access to the data and had final responsibility for the decision to submit for publication.
Funding This study was funded by the Guys and St Thomas’ Charity as part of a larger evaluation of the SH:24 online sexual health service. The research by IB is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King’s College Hospital NHS Foundation Trust, King’s College London.
Disclaimer The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, the Department of Health or Public Health England.
Competing interests PB is a director of SH:24.
Ethics approval Ethical approval was obtained from the NRES Committee North of Scotland, Grampian (Ref 15/NS/0031).
Provenance and peer review Not commissioned; externally peer reviewed.
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