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Legislation and regulation in the era of online sexual health: how do we ensure provision of safe, high-quality care?
  1. Jo Gibbs1,
  2. Soazig Clifton1,
  3. Pam Sonnenberg1,
  4. Ann Blandford2,
  5. Anne M Johnson1,
  6. Claudia S Estcourt3
  1. 1 Institute for Global Health, University College London, London, UK
  2. 2 Department of Computer Science, University College London, London, UK
  3. 3 School of Health and Life Science, Glasgow Caledonian University, Glasgow, UK
  1. Correspondence to Dr Jo Gibbs, Centre for Population Research in Sexual Health and HIV, Institute for Global Health, Mortimer Market Centre, London WC1E 6JB, UK; jo.gibbs{at}

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Advances in digital health and novel diagnostics for STIs and HIV have created new opportunities for people to access information, testing and, in some cases, treatment remote from traditional healthcare settings.

Legislation and regulation can facilitate or impede innovation in service delivery. For example, the Health and Social Care Act of 2012 moved responsibility for public health, including the majority of sexual health services, from the National Health Service (NHS) to local government. Shifts in commissioning and service delivery have occurred, with major disinvestment in sexual health services, which has led to innovative models of care being introduced, including online services.1

There is an underlying but un-evidenced assumption that online sexual health services will preserve access and increase uptake at a reduced cost. This has led many services to introduce or expand their online presence, which ranges from simple unidirectional health promotion to more ambitious self-sampling services that aim to ‘channel shift’ those without symptoms away from face-to-face services and into online care.

All healthcare professionals, healthcare services, and the medicines and devices they use are regulated, whether care is ‘traditional’ or remote, including online. Most regulations were established in the pre-digital era, although many professional bodies in the UK have adapted their existing guidance to incorporate online services. There are three key areas of regulation that are particularly relevant to online care:

  1. Safety …

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  • Handling editor Jackie A Cassell

  • Funding The work included within this article was funded by (1) The Electronic Self-Testing Instruments for Sexually Transmitted Infection (eSTI2) Consortium, funded under the UKCRC Translational Infection Research (TIR) Initiative supported by the Medical Research Council (grant no. G0901608) with contributions to the Grant from the Biotechnology and Biological Sciences Research Council, the National Institute for Health Research on behalf of the Department of Health, the Chief Scientist Office of the Scottish Government Health Directorates and the Wellcome Trust; (2) an i-sense Partnership Resource Fund, as part of a larger Engineering and Physical Sciences Research Council UK (EPSRC) project (grant no. EP/K031953/1).

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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