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Original article
Evaluation and enumeration of online test providers for sexually transmitted infections, specifically chlamydia, in the Netherlands
  1. Chantal den Daas1,2,
  2. Bob Sukel1,
  3. Hanna Bos3,
  4. Ingrid van den Broek I1
  1. 1 Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
  2. 2 Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
  3. 3 Professionals, STI Aids Netherlands, Amsterdam, The Netherlands
  1. Correspondence to Dr Chantal den Daas, National Institute for Public Health and the Environment, Bilthoven 3720, The Netherlands; chantal.den.daas{at}


Objectives Online testing for STIs might complement regular care provided by general practitioners or STI clinics. Two types of online testing can be distinguished, self-testing and self-sampling (sending sample to a laboratory for diagnosis). Online testing can occur without consultation with a healthcare professional, therefore information given by providers is essential for informed decision-making. We aimed to enumerate online test providers in the Netherlands focusing on chlamydia tests, to evaluate information using quality indicators and to gain insight on the proportion of online testing in the STI testing arena.

Methods We performed a systematic internet search to identify online STI test providers. Twenty quality indicators were evaluated on their websites; indicator scores were weighted by level of importance (expert opinion). High scoring providers were recommended, on the condition that the sensitivity and specificity of the test were above 95% and providers included a follow-up procedure in case of a positive result. Finally, providers were contacted to inquire about the number of sold tests, positivity rates and demographic characteristics of testers.

Results Five out of 12 identified self-sample test providers could be recommended, versus zero out of eight self-test providers. Self-sample test providers gave complete and correct information on more indicators (67%) compared with self-test providers (38%). In 2015, an estimated 30 000–40 000 self-sample tests were purchased, and 12 000–25 000 self-tests, which is roughly 10%–15% of the total number of STI tests.

Conclusion This evaluation shows that some online self-sample test providers could be put forward as way of STI testing complementing regular testing options. None of the self-test providers were recommended. Regularly evaluating online test providers is advised to improve quality of the information on the websites. Finally, self-testing might not be suited for all populations as most information is provided in written format only.

  • Chlamydia
  • self-test
  • self-sample test
  • online providers
  • quality assessment

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Handling editor Claudia S Estcourt

  • Contributors All authors contributed to the design of the study. CdD, BS and IvdB led on the data analysis. CdD drafted the manuscript supported by BS, HB and IvdB. All authors commented on drafts of the manuscript and approved the final version.

  • Competing interests None declared.

  • Patient consent for publication Not required

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

  • Data sharing statement We have the scores per self-test provider (unaggregated) on the 20 quality indicators, which can be made available upon request.

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