Table 1

Summary of recommendations from the BASHH standards for the management of STIs7 and the joint BASHH/Faculty of Sexual and Reproductive Healthcare (FSRH) standards for online and remote providers of sexual and reproductive health services8

ThemeSummaryRelevant BASHH standards7*Relevant FSRH/BASHH standards8*
1. Test audience and pretest process
  • Symptomatic patients are not advised to use online services (however this guidance was modified due to COVID-19 to maintain access to services, and low-risk symptomatic patients could use online services).18

  • Providers of STI care should have in place an effective triage system to direct users to the most appropriate service. Services should take a medical and sexual history.

  • Those who need HIV postexposure prophylaxis should not use online services and should be directed to a clinic.

1.2.6
1.5.7
1.5.8
1.5.9
1.5.10
2.4.5
2.4.7
2.4.8
2.5.2
2.5.8
3.1.3
3.2.3
2. Test process
  • Specimens for chlamydia, gonorrhoea, syphilis and HIV should be taken from all exposed sites as a minimum.

  • Specimens for microbiological testing obtained during the examination should be in line with national guidance.

  • All providers of services commissioned to manage STIs should use the ‘gold standard’ test for the infection they are screening for.

  • Service users should be advised about the sensitivity of the assays for detecting infection.

2.4.5
2.4.8
2.5.11
2.5.14
2.5.15
3.4.2
3.4.4
3.4.8
3.4.10
3.5.1
3.5.6
3.3.2
3.3.3
3. Health information
  • Service users should be fully informed on the nature and limitations of the test, as well as have access to health promotion and prevention interventions including encouragement of safer sex behaviour and condom usage.

2.4.5
2.5.12
2.1.6
3.3.3
4. Postdiagnosis actions
  • Clear pathways with choices for individuals to obtain care, treatment and further management must be available if an STI is identified. Service users must be given information on the need for partner notification, re-testing as appropriate and advised that this is part of STI management.

  • If services are unable to provide specialist support or additional tests, the provider should be able to provide onwards referral.

  • Treatment should follow national guidelines.

2.4.5
2.4.10
4.4.1
4.4.8
4.4.11
4.4.16
4.5.5
4.5.13
8.4.6
8.4.8
1.1.12
1.1.13
3.5.6
5. Accreditation
  • Service providers should have relevant accreditation such as CE-marked products, United Kingdom Accreditation Services accredited laboratories and be registered with the Care Quality Commission.

  • Services should comply with the joint FSRH/BASHH standards for online providers8 and other BASHH guidelines.

2.4.1
2.5.1
3.4.1
3.5.4
3.5.10
3.5.12
6.4.8
1.4.2
1.4.12
3.3.1
  • These were used to assess whether online providers were providing an adequate standard of care to patients.

  • *Not all standards or all aspects of each standard were able to be measured due to the nature of information available on provider websites.