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Internet-based testing for STIs doubles uptake

Findings from first UK study to compare effect of access to internet-based STI testing against face-to-face appointments

Ingrid Torjesen

Tuesday, 02 January 2018

Offering internet-based testing for STIs nearly doubles the uptake of testing, found a randomised controlled trial* among people living in Lambeth and Southwark in South London.

The study led by the London School of Hygiene & Tropical Medicine and King's College London, in partnership with SH:24, a digital sexual health service, involved more than 2,000 people.

Participants were randomly allocated to receive one of two text messages. The control group was sent a text message with a link listing the locations, contact details and websites of seven local sexual health clinics. The intervention group received a message linking them to the e-STI testing and results service, SH:24.

The group given details of SH:24 was offered postal self-sampling test kits for chlamydia, gonorrhoea, HIV and syphilis, and when returned, were given results via text message or telephone and provided with online information about safe sex and sexual health.

All participants were free to use any other services or interventions during the study period.

The results, published in Plos Medicine, showed that, after six weeks, the uptake of testing was increased in those offered e-STI testing at 50% compared to 26.6% in the control group. The proportion of participants diagnosed with an STI was 2.8% in the intervention group versus 1.4% in the control group.

First author Emma Wilson from the London School of Hygiene & Tropical Medicine said: "E-STI testing is currently being implemented in the UK as one measure to meet increasing demand for STI testing, but there is surprisingly little evidence on whether it successfully encourages uptake. Our study, the first of its kind, aimed to investigate the effectiveness of e-STI testing for syphilis, HIV, chlamydia and gonorrhoea."

In England, there were more than 400,000 new diagnoses of STIs, and 5,684 new cases of HIV, in 2015. In 2016, there were more than 100,000 new STIs diagnosed in London residents and London accounted for almost half of new HIV diagnoses in the UK in 2015.

Joint senior investigator Caroline Free from the London School of Hygiene & Tropical Medicine said:

"Sexual health clinics play an important role in community health but some people may find them inconvenient or stigmatising, which can stop them attending. More long-term monitoring and evaluation of e-STI testing services is needed, but our study showed that when e-STI testing was made available alongside face-to-face services, the number of people getting tested for STIs nearly doubled."

Joint senior investigator Dr Paula Baraitser from Kings College London, said: "Although the intervention group were given information to access an e-STI service, some of them chose to use face-to-face services instead of e-STI testing. Therefore, it is important that both online and clinical based services are available to meet the differing needs of people.”


* Wilson E, Free C, Morris TP, et al. Internet-accessed sexually transmitted infection (e-STI) testing and results service: A randomised, single-blind, controlled trial. PLoS Med 14(12): e1002479. 10.1371/journal.pmed.1002479

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