Internet testing for Chlamydia trachomatisin England, 2006 to 2010

Abstract

BackgroundIn recent years there has been interest in websites as a means of increasing access to free chlamydia tests through the National Chlamydia Screening Programme (NCSP) in England. We aimed to describe and evaluate online access to chlamydia testing within the NCSP.MethodsWe analysed NCSP chlamydia testing data (2006–2010) for 15–24 year olds from the 71/95 programme areas in England where site codes were available to identify tests ordered through the internet. The characteristics of people using online testing services in 2010 were compared with those testing in general practice (GP) or community sexual and reproductive health (SRH) services. We evaluated 58 websites offering free chlamydia tests through the NCSP, and 32 offering kits on a commercial basis for signposting to clinical service and health promotion advice offered.ResultsBetween 2006 and 2010, 5% of all tests in the included programme areas were accessed through the internet. The number of internet tests increased from 18 (<1% of all tests) in 2006 to 59,750 in 2010 (6% of all NCSP tests). In 2010 the proportion of NCSP tests accessed online by programme area ranged from <1% to 38%. The proportion of tests with a positive result on the internet was higher than tests from general practice and comparable to those from community SRH services (internet 7.6%; GP 5.6%; Community SRH 8.2%). A higher proportion of people accessing online testing were male, aged 20–24 and reported >1 sexual partner in the past year. Provision of sexual health information and appropriate signposting for those in need of clinical services varied between websites. Service provision within the NCSP was fragmented with multiple providers serving specific geographical catchment areas.ConclusionInternet testing reaches a population with a relatively high risk of chlamydia infection and appears acceptable to young men, a group that has been difficult to engage with chlamydia testing. In order to maximise the potential benefit of these services, websites should be consistent with national guidelines and adhere to minimum standards for signposting to clinical care and health promotion information. The current system with multiple providers servicing geographically specific catchment areas is contrary to the geographically unrestricted nature of the internet and potentially confusing for clients.

Non-participation in chlamydia screening in the Netherlands: determinants associated with young people’s intention to participate in chlamydia screening

“…the use of Internet independent of geographic area [28], financial incentives [29], a focus on self-identity [30], and/or the use of social media in combination with role models (people who disclose that they have tested) to overcome low susceptibility and lack of supportive social norms [31]. …”

Get Tested Why Not? A Novel Approach to Internet-based Chlamydia and Gonorrhea Testing in Canada

“…This finding supports the conclusion that men have a high acceptability of online chlamydia and gonorrhea testing. 10 Further research is needed not only to understand the effectiveness and outcomes of online STI testing in the youth and adult populations, but also to determine how to influence uptake through traditional and non-traditional advertising and promotion.…”

Health Innovation Project: A Concept Paper on a Virtual Health Promotion Program for Men

“…39,40 For example, Internet-initiated chlamydia testing has been found to be acceptable among young men. 41 These ICT applications offer easy access to health information for men at their convenience and in privacy. This health promotion information may not necessarily require advice from a medical practitioner.…”