Introduction During the COVID-19 pandemic many sexual health service users were directed to online care to facilitate remote management, which may exclude those unable or unwilling to engage online. We explored differences in characteristics of those reporting using online STI testing services relative to those who reported using other testing services during the first year of the pandemic.

Methods Natsal-COVID, a web-panel survey conducted through survey research company Ipsos, asked participants aged 18–59 years about their sexual health experiences in the year beginning 23 March 2020 (beginning of first British lockdown). Quota-based sampling and weighting were used to achieve a sample quasi-representative of Britain’s population. We describe socio-demographic and health characteristics of participants reporting using online STI testing services, defined as services where patients did not interact with clinicians live (e.g., online postal self-sampling) and excluded video/phone calls. We compare these “online service users” to those who used only other services such as face-to-face, telephone, or video calls (“other service users”).

Results Of 6,064 participants, 246 (4.2% (95%CI 3.7–4.8) reported using STI testing services between March 2020-March 2021. Of those, 77 (35.8% (95%CI 29.2–42.8) reported online service use and 139 (56.5% (95%CI 49.5–63.2) reported other service use. Compared to other service users, online users were more often 25–29 years old (38.2% vs. 25.3%), but less often <25 years old (27.0% vs. 38.0%). Online service users (compared to other users) were more often white (74.9% vs. 68.5%), reported being in good health (86.0% vs. 75.0%), and less often reported symptoms of depression (38.6% vs. 50.9%) and anxiety (39.0% vs. 57.2%).

Discussion Our findings suggest variations in the characteristics of people accessing online compared to other STI testing services. Caution is needed given small numbers and overlapping confidence intervals, but this might indicate inequalities in online service access which need further investigation and mitigation.