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Does internet-accessed STI (e-STI) testing increase testing uptake for chlamydia and other STIs among a young population who have never tested? Secondary analyses of data from a randomised controlled trial.
Sex Transm Infect. 2019 12; 95(8):569-574.ST

Abstract

OBJECTIVES

To assess the effectiveness of an internet-accessed STI (e-STI) testing and results service on testing uptake among young adults (16-30 years) who have never tested for STIs in London, England.

METHODS

We conducted secondary analyses on data from a randomised controlled trial. In the trial, participants were randomly allocated to receive a text message with the web link of an e-STI testing and results service (intervention group) or a text message with the link of a website listing the locations, contact details and websites of seven local sexual health clinics (control group). We analysed a subsample of 528 trial participants who reported never testing for STIs at baseline. Outcomes were self-reported STI testing at 6 weeks, verified by patient record checks, and time from randomisation to completion of an STI test.

RESULTS

Uptake of STI testing among 'never testers' almost doubled. At 6 weeks, 45.3% of the intervention completed at least one test (chlamydia, gonorrhoea, syphilis and HIV), compared with 24.1% of the control (relative risk [RR] 1.88, 95% CI 1.47 to 2.40, p<0.001). For chlamydia and gonorrhoea testing combined, uptake was 44.3% in the intervention versus 24.1% in controls (RR 1.84, 95% CI 1.44 to 2.36, p<0.001). The intervention reduced time to any STI test (restricted mean survival time: 29.0 days vs 36.3 days, p<0.001) at a time horizon of 42 days. CONCLUSIONS : e-STI testing increased uptake of STI testing and reduced time to test among a young population of 'never testers' recruited in community settings. Although encouraging, questions remain on how best to manage the additional demand generated by e-STI testing in a challenging funding environment. Larger studies are required to assess the effects later in the cascade of care, including STI diagnoses and cases treated.

Authors+Show Affiliations

Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK emma.wilson@lshtm.ac.uk.Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.Department of Sexual Health and HIV, King's College Hospital NHS Foundation Trust, London, UK. School of Population Health and Environmental Sciences, King's College London, London, UK.Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31175210

Citation

Wilson, Emma, et al. "Does Internet-accessed STI (e-STI) Testing Increase Testing Uptake for Chlamydia and Other STIs Among a Young Population Who Have Never Tested? Secondary Analyses of Data From a Randomised Controlled Trial." Sexually Transmitted Infections, vol. 95, no. 8, 2019, pp. 569-574.
Wilson E, Leyrat C, Baraitser P, et al. Does internet-accessed STI (e-STI) testing increase testing uptake for chlamydia and other STIs among a young population who have never tested? Secondary analyses of data from a randomised controlled trial. Sex Transm Infect. 2019;95(8):569-574.
Wilson, E., Leyrat, C., Baraitser, P., & Free, C. (2019). Does internet-accessed STI (e-STI) testing increase testing uptake for chlamydia and other STIs among a young population who have never tested? Secondary analyses of data from a randomised controlled trial. Sexually Transmitted Infections, 95(8), 569-574. https://doi.org/10.1136/sextrans-2019-053992
Wilson E, et al. Does Internet-accessed STI (e-STI) Testing Increase Testing Uptake for Chlamydia and Other STIs Among a Young Population Who Have Never Tested? Secondary Analyses of Data From a Randomised Controlled Trial. Sex Transm Infect. 2019;95(8):569-574. PubMed PMID: 31175210.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does internet-accessed STI (e-STI) testing increase testing uptake for chlamydia and other STIs among a young population who have never tested? Secondary analyses of data from a randomised controlled trial. AU - Wilson,Emma, AU - Leyrat,Clémence, AU - Baraitser,Paula, AU - Free,Caroline, Y1 - 2019/06/07/ PY - 2019/01/29/received PY - 2019/05/01/revised PY - 2019/05/05/accepted PY - 2019/6/9/pubmed PY - 2020/2/12/medline PY - 2019/6/9/entrez KW - diagnosis KW - programme evaluation KW - service delivery KW - testing SP - 569 EP - 574 JF - Sexually transmitted infections JO - Sex Transm Infect VL - 95 IS - 8 N2 - OBJECTIVES: To assess the effectiveness of an internet-accessed STI (e-STI) testing and results service on testing uptake among young adults (16-30 years) who have never tested for STIs in London, England. METHODS: We conducted secondary analyses on data from a randomised controlled trial. In the trial, participants were randomly allocated to receive a text message with the web link of an e-STI testing and results service (intervention group) or a text message with the link of a website listing the locations, contact details and websites of seven local sexual health clinics (control group). We analysed a subsample of 528 trial participants who reported never testing for STIs at baseline. Outcomes were self-reported STI testing at 6 weeks, verified by patient record checks, and time from randomisation to completion of an STI test. RESULTS: Uptake of STI testing among 'never testers' almost doubled. At 6 weeks, 45.3% of the intervention completed at least one test (chlamydia, gonorrhoea, syphilis and HIV), compared with 24.1% of the control (relative risk [RR] 1.88, 95% CI 1.47 to 2.40, p<0.001). For chlamydia and gonorrhoea testing combined, uptake was 44.3% in the intervention versus 24.1% in controls (RR 1.84, 95% CI 1.44 to 2.36, p<0.001). The intervention reduced time to any STI test (restricted mean survival time: 29.0 days vs 36.3 days, p<0.001) at a time horizon of 42 days. CONCLUSIONS : e-STI testing increased uptake of STI testing and reduced time to test among a young population of 'never testers' recruited in community settings. Although encouraging, questions remain on how best to manage the additional demand generated by e-STI testing in a challenging funding environment. Larger studies are required to assess the effects later in the cascade of care, including STI diagnoses and cases treated. SN - 1472-3263 UR - https://www.unboundmedicine.com/medline/citation/31175210/Does_internet_accessed_STI__e_STI__testing_increase_testing_uptake_for_chlamydia_and_other_STIs_among_a_young_population_who_have_never_tested_Secondary_analyses_of_data_from_a_randomised_controlled_trial_ L2 - https://sti.bmj.com/lookup/pmidlookup?view=long&amp;pmid=31175210 DB - PRIME DP - Unbound Medicine ER -