Background Internet-based screening for sexually-transmitted infections (STIs) has been acceptable to women, and can reach high-risk populations. No prior literature describes internet-based screening for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis in men. We studied whether internet-based screening was acceptable and reached a high-risk population, and what risk factors were associated with STI positivity. Methods The website, www.iwantthekit.org, encouraged men ≥ 14 years of age to request a home self-sampling kit and a questionnaire on risk factors and acceptability of internet-based screening. Penile swabs and urine samples were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis using a nucleic acid amplification test. Risk factors and acceptability were examined using chi-squared tests and logistic regression. Results Of 501 samples received for testing, 106 (21%) were positive for at least one STI, 64 (13%) for chlamydia, 4 (1%) for gonorrhea, and 49 (10%) for trichomonas. In multivariable analyses, age, race, household income, and frequency of condom use were independently associated with infection with at least one STI. Of respondents, 34% had a prior STI; 29% reported having a partner with an STI, but only 13% reported always using a condom. Seventy-seven percent of men preferred a self-administered specimen versus attending a clinic, 89% reported swab use was easy, and 89% would use internet-based screening again. Conclusions Men who access internet-based screening had known risk factors for STIs and had a high prevalence of infection. Internet-based screening was acceptable and could access these high-risk men, who might not otherwise be reached through traditional means.

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Background Submission of self-obtained vaginal samples (SOVs) collected at home could remove barriers that women face in getting tested for sexually transmitted infections (STIs). Internet-recruitment of SOVs is highly acceptable. Methods Sexually active women ≥ 14 yr were recruited by an educational Internet program www.iwantthekit.org (IWTK) which offered free testing for trichomonas as part of a panel, which also offered testing for chlamydia and gonorrhea. Kits were ordered on-line, SOVs were sent via U.S. mail to the laboratory, and tested by nucleic acid amplification tests (NAATs). Demographics and sexual risk factors were accessed by questionnaires. Women called or were contacted to receive their results. Results Of women requesting kits, 1525 (43%) returned swabs by mail. Sixty-one percent were <25 yr, 52% were Black, and 80% were single. Vaginal discharge was reported by 44%, prevalence for trichomonas was 10%, (10% for chlamydia, 1% for gonorrhea), and 18% had at least one prevalent STI. Multivariate logistic regression demonstrated several significantly associated risks factors: Black Race adjusted odds ratios (OR) 2.69; residence of Illinois OR 3.85; not having health insurance OR 1.57; lack of a bachelor’s degree OR 5.53; having 2–15 partners OR 1.60; having ≥16 partners in previous year OR 3.51; being bi-sexual OR 2.0; not always using condoms OR 3.04; and having a partner who had a previous STI OR 1.71. Age was not associated with trichomonas infection. All infected women were treated. Conclusions A high prevalence of trichomonas and high sexual risk factors were demonstrated. Internet recruitment was a useful method of screening women for trichomonas infection.

Cardiac EASE reduced wait times, increased capacity and shortened time to achieve a diagnosis. The EASE model could shorten wait times for consultative services in Canada.