Article Text
Abstract
Objectives Since 2018, Sexual Health London (SHL) has provided remote sexually transmitted infection (STI) testing services to London residents over 16 years of age. SHL was an asymptomatic screening service. In 2020, SHL widened access to non-urgent symptomatic testing. We undertook a 4-year evaluation on the uptake of SHL’s online testing pathway and outcomes, including the association of positive chlamydia and gonorrhoea nucleic acid amplification test (NAAT) outcomes with user demographics and user utility.
Methods This is a retrospective data analysis of routine SHL clinical data from 8 January 2018 to 31 March 2022 of all STI test kit orders, focusing on HIV, chlamydia and gonorrhoea outcomes. Descriptive analysis on uptake of each stage of SHL’s clinical care pathway is provided, including HIV testing outcomes. Binary logistic regression was used to examine the association between SHL user-completed online consultation information, SHL uptake and chlamydia and gonorrhoea NAAT results (negative or positive).
Results During the evaluation period, there were 1 476 187 orders made by 670 293 unique users. The return rate for chlamydia and gonorrhoea NAATs was 79.5% and 67.6% for HIV blood samples. The positivity rate from sufficient samples was 4.5% for chlamydia, 1.6% for gonorrhoea and 0.3% reactivity for HIV. There were increased odds of a positive chlamydia and gonorrhoea NAAT result in non-cisgender women, those with a high number of STI orders, non-UK born and those who collected an STI test kit from a clinic-based service.
Conclusions To date, this is the largest number of orders in an evaluation of online postal sexual health infection testing in the UK, and highest return rate of samples, suggesting acceptability of SHL for STI testing. Positivity rates for chlamydia and gonorrhoea NAAT tests are lower than national figures, which may reflect asymptomatic screening prior to 2020 and testing of non-urgent symptoms since 2020.
- delivery of health care
- HIV
- sexual health
Data availability statement
Data may be obtained from a third party and are not publicly available. Data were provided by Preventx with permission from SHL’s data controller.
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Data availability statement
Data may be obtained from a third party and are not publicly available. Data were provided by Preventx with permission from SHL’s data controller.
Footnotes
Handling editor Nadja A Vielot
X @jogibbs76
Contributors VT designed, supported data acquisition, analysed and drafted the manuscript. JS and AT led on the data acquisition. SLD and AMK supported data acquisition. SLD, AT, AH, JG, FB and AS supported the design, analysis and drafting of the manuscript. AS conceived the evaluation. All authors supported revision of the manuscript. VT is the guarantor.
Funding VT received partial funding from City of London to support her work on this analysis.
Competing interests VT received supplementary funding from City of London to undertake the analysis. However, City of London had no role in the design of the evaluation. No other competing interests were declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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