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Short report
Mixed-methods evaluation of a novel online STI results service
  1. Jo Gibbs1,2,
  2. Catherine R H Aicken1,
  3. Lorna J Sutcliffe2,
  4. Voula Gkatzidou3,
  5. Laura J Tickle2,
  6. Kate Hone3,
  7. S Tariq Sadiq4,
  8. Pam Sonnenberg1,
  9. Claudia S Estcourt2,5
  1. 1 Centre for Population Research in Sexual Health and HIV, Institute of Global Health, University College London, London, UK
  2. 2 Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
  3. 3 College of Engineering, Design and Physical Sciences, Brunel University London, Uxbridge, UK
  4. 4 Applied Diagnostic Research and Evaluation Unit, Institute for Infection and Immunity, St George’s University of London, London, UK
  5. 5 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, UCL Institute of Global Health, London WC1E 6JB, UK; jo.gibbs{at}


Objectives Evidence on optimal methods for providing STI test results is lacking. We evaluated an online results service, developed as part of an eSexual Health Clinic (eSHC).

Methods We evaluated the online results service using a mixed-methods approach within large exploratory studies of the eSHC. Participants were chlamydia- positive and negative users of online postal self-sampling services in six National Chlamydia Screening Programme (NCSP) areas and chlamydia-positive patients from two genitourinary medicine (GUM) clinics between 21 July 2014 and 13 March 2015. Participants received a discreetly worded National Health Service ’NHS no-reply’ text message (SMS) informing them that their test results were ready and providing a weblink to a secure website. Participants logged in with their date of birth and mobile telephone or clinic number. Chlamydia-positive patients were offered online management. All interactions with the eSHC system were automatically logged and their timing recorded. Post-treatment, a service evaluation survey (n=152) and qualitative interviews (n=36) were conducted by telephone. Chlamydia-negative patients were offered a short online survey (n=274). Data were integrated.

Results 92% (134/146) of NCSP chlamydia-positive patients, 82% (161/197) of GUM chlamydia-positive patients and 89% (1776/1997) of NCSP chlamydia-negative participants accessed test results within 7 days. 91% of chlamydia-positive patients were happy with the results service; 64% of those who had tested previously found the results service better or much better than previous experiences. 90% of chlamydia-negative survey participants agreed they would be happy to receive results this way in the future. Interviewees described accessing results with ease and appreciated the privacy and control the two-step process gave them.

Conclusion A discreet SMS to alert users/patients that results are available, followed by provision of results via a secure website, was highly acceptable, irrespective of test result and testing history. The eSHC results service afforded users privacy and control over when they viewed results without compromising access.

  • chlamydia infection
  • clinical sti care
  • testing
  • service delivery

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  • Handling editor Jackie A Cassell

  • Contributors This paper was conceived by JG. JG wrote the first draft, with contributions from CRHA, KH, PS and CSE. JG, LJS, VG and CSE developed the results service as part of the eSexual Health Clinic. JG, CRHA, LJS, VG and CSE evaluated the results service with JG leading the analysis of quantitative data and CA leading the analysis of qualitative data. KH, STS (Principal Investigator), PS and CSE were applicants on the eSTI2 Consortium grant and wrote the initial protocol and obtained funding. PS led the Clinical, Public Health and Economics work stream. CSE led the exploratory studies of the Online Chlamydia Pathway with contributions from JG, LJS, VG, KH, STS and PH. All authors read and approved the final manuscript.

  • Funding The Electronic Self-Testing Instruments for Sexually Transmitted Infection (eSTI2) Consortium is funded under the UKCRC Translational Infection Research (TIR) initiative supported by the Medical Research Council (Grant Number 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.

  • Competing interests None declared.

  • Ethics approval Brighton and Sussex (NHS) Research Ethics Committee reference 13/LO/1111.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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