Fully Integrated e-Services for Prevention, Diagnosis, and Treatment of Sexually Transmitted Infections: Results of a 4-County Study in California

Spielberg, Freya; Levy, Vivian; Lensing, Shelly; Chattopadhyay, Ishita; Venkatasubramanian, Lalitha; Acevedo, Nincoshka; Wolff, Peter; Callabresi, Debra; Philip, Susan; Lopez, Travis; Padian, Nancy; Blake, Diane R.; Gaydos, Charlotte A.

doi:10.2105/ajph.2014.302302

Cited by 29 publications

(21 citation statements)

References 15 publications

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“…Only 4 publications included the proportion of cases treated, which ranged from 62% in the “eSTI” program in 4 California counties, 41 87% in the Los Angeles “I Know” program, to greater than 95% in the “iwantthekit.org”program. 54,56 No publications reported rates of partner management.…”

Section: Resultsmentioning

confidence: 99%

Bacterial Sexually Transmitted Disease Screening Outside the Clinic—Implications for the Modern Sexually Transmitted Disease Program

Bernstein

Chow

Pathela

et al. 2016

Sexually Transmitted Diseases

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Background The development of noninvasive nucleic acid amplification tests for chlamydia and gonorrhea has facilitated innovation in moving sexually transmitted disease (STD) screening to nonclinical settings. However, limited data are available to inform local STD programs on evidence-based approaches to STD screening in nonclinical settings in the United States. Methods We conducted a systematic review of the literature published since 2000 related to chlamydia, gonorrhea, and syphilis screening in US correctional settings, bathhouses and sex venues, self-collected at-home testing, and other nonclinical sites. Results Sixty-four articles met eligibility criteria and were reviewed. Although data on testing volume and positivity were available, there were scarce data on the proportion of new positives treated and the programmatic costs for the various screening programs. Screening in correctional settings identified a sizable amount of asymptomatic infections. The value and sustainability of screening in the other nonclinical settings examined was not clear from the published literature. Conclusions Local and state health departments should explore the development of sustainable jail and juvenile detention screening programs for STDs. Furthermore, local programs should pilot outreach and home-based STD screening programs to determine if they are identifying asymptomatic persons who would not have otherwise been found. Local programs are encouraged to present and publish their findings related to non–clinic-based screening to enhance the limited body of literature; data on the proportion of new infections treated and the local program costs are needed.

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Section: Resultsmentioning

confidence: 99%

Bacterial Sexually Transmitted Disease Screening Outside the Clinic—Implications for the Modern Sexually Transmitted Disease Program

Bernstein

Chow

Pathela

et al. 2016

Sexually Transmitted Diseases

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“…A demonstration of an online STD management service (eSTI) across four California counties provides a case in point. 44 Integrated online management of testing, treatment, partner notification options, and linkage to care for chlamydia, gonorrhea, and trichomoniasis brought services and found cases for infections unlikely to be managed through PN alone. There was diminishing support over time for home sampling, which was also costly.…”

Section: Discussionmentioning

confidence: 99%

Partner Services in Sexually Transmitted Disease Prevention Programs

Hogben¹,

Collins²,

Hoots³

et al. 2016

Sexually Transmitted Diseases

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Background Partner services have been a mainstay of public health sexually transmitted disease (STD) prevention programs for decades. The principal goals are to interrupt transmission and reduce STD morbidity and sequelae. In this paper, we review current literature with the goal of informing STD prevention programs. Methods We searched the literature for systematic reviews. We found nine reviews published between 2005 and 2014 (covering 108 studies). The reviews varied by study inclusion criteria (e.g., study methods, geographic location, infections). We abstracted major conclusions and recommendations from the reviews. Results Conclusions and recommendations were divided into patient referral interventions and provider referral interventions. For patient referral, there was evidence supporting the use of expedited partner therapy and interactive counseling, but not purely didactic instruction. Provider referral through Disease Intervention Specialists was efficacious and particularly well-supported for HIV. For other studies, modeling data and testing outcomes showed that partner notification in general reached high-prevalence populations. Reviews also suggested more focus on using technology and population-level implementation strategies. However, partner services may not be the most efficient means to reach infected persons. Conclusions Partner services programs constitute a large proportion of program STD prevention activities. Value is maximized by balancing a portfolio of patient and provider referral interventions and by blending partner notification interventions with other STD prevention interventions in overall partner services program structure. STD prevention needs program-level research and development to generate this portfolio.

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“…Internet access is now nearly universal among people of reproductive age in the United Kingdom (98% aged 16-34 years, 93% aged 35-44 years in 2013) and more than one-third regularly uses the Internet to find information on health-related issues [ 11 ]. Although new Internet-based sexual health services continue to be developed [ 12 - 15 ], the number and characteristics of people who use currently available online sexual health services in Britain are unknown. To inform the design and delivery of new online sexual health interventions and services, we need to understand the demographic and behavioral characteristics of existing users.…”

Section: Introductionmentioning

confidence: 99%

Use of the Internet for Sexual Health Among Sexually Experienced Persons Aged 16 to 44 Years: Evidence from a Nationally Representative Survey of the British Population

Aicken¹,

Estcourt²,

Johnson³

et al. 2016

J Med Internet Res

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BackgroundThose who go online regarding their sexual health are potential users of new Internet-based sexual health interventions. Understanding the size and characteristics of this population is important in informing intervention design and delivery.ObjectiveWe aimed to estimate the prevalence in Britain of recent use of the Internet for key sexual health reasons (for chlamydia testing, human immunodeficiency virus [HIV] testing, sexually transmitted infection [STI] treatment, condoms/contraceptives, and help/advice with one’s sex life) and to identify associated sociodemographic and behavioral factors.MethodsComplex survey analysis of data from 8926 sexually experienced persons aged 16-44 years in a 2010-2012 probability survey of Britain’s resident population. Prevalence of recent (past year) use of Internet sources for key sexual health reasons was estimated. Factors associated with use of information/support websites were identified using logistic regression to calculate age-adjusted odds ratios (AORs).ResultsRecent Internet use for chlamydia/HIV testing or STI treatment (combined) was very low (men: 0.31%; women: 0.16%), whereas 2.35% of men and 0.51% of women reported obtaining condoms/contraceptives online. Additionally, 4.49% of men and 4.57% of women reported recent use of information/support websites for advice/help with their sex lives. Prevalence declined with age (men 16-24 years: 7.7%; 35-44 years: 1.84%, P<.001; women 16-24 years: 7.8%; 35-44 years: 1.84%, P<.001). Use of information/support websites was strongly associated with men’s higher socioeconomic status (managerial/professional vs semiroutine/routine: AOR 1.93, 95% CI 1.27-2.93, P<.001). Despite no overall association with area-level deprivation, those in densely populated urban areas were more likely to report use of information/support websites than those living in rural areas (men: AOR 3.38, 95% CI 1.68-6.77, P<.001; women: AOR 2.51, 95% CI 1.34-4.70, P<.001). No statistically significant association was observed with number of sex partners reported after age adjustment, but use was more common among men reporting same-sex partners (last 5 years: AOR 2.44, 95% CI 1.27-4.70), women reporting sex with multiple partners without condoms (last year: AOR 1.90, 95% CI 1.11-3.26), and, among both sexes, reporting seeking sex online (last year, men: AOR 1.80, 95% CI 1.16-2.79; women: AOR 3.00, 95% CI 1.76-5.13). No association was observed with reporting STI diagnosis/es (last 5 years) or (after age adjustment) recent use of any STI service or non-Internet sexual health seeking.ConclusionsA minority in Britain used the Internet for the sexual health reasons examined. Use of information/support websites was reported by those at greater STI risk, including younger people, indicating that demand for online STI services, and Internet-based sexual health interventions in general, may increase over time in this and subsequent cohorts. However, the impact on health inequalities needs addressing during design and evaluation of online sexual health int...

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Fully Integrated e-Services for Prevention, Diagnosis, and Treatment of Sexually Transmitted Infections: Results of a 4-County Study in California

Abstract: The fully integrated eSTI system has the potential to increase diagnosis and treatment of STIs with higher patient satisfaction at a potentially lower cost.

Cited by 29 publications

References 15 publications

Bacterial Sexually Transmitted Disease Screening Outside the Clinic—Implications for the Modern Sexually Transmitted Disease Program

Bacterial Sexually Transmitted Disease Screening Outside the Clinic—Implications for the Modern Sexually Transmitted Disease Program

Partner Services in Sexually Transmitted Disease Prevention Programs

Use of the Internet for Sexual Health Among Sexually Experienced Persons Aged 16 to 44 Years: Evidence from a Nationally Representative Survey of the British Population

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