Internet-accessed sexually transmitted infection (e-STI) testing and results service: A randomised, single-blind, controlled trial

Wilson, E; Free, C; Morris, TP; Syred, J; Ahamed, I; Menon-Johansson, AS; Palmer, MJ; Barnard, S; Rezel, E and Baraitser, P (2017). Internet-accessed sexually transmitted infection (e-STI) testing and results service: A randomised, single-blind, controlled trial. [Dataset]. PLOS Medicine, London, United Kingdom. https://doi.org/10.1371/journal.pmed.1002479
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Internet-accessed sexually transmitted infection testing (e-STI testing) is increasingly available as an alternative to testing in clinics. Typically this testing modality enables users to order a test kit from a virtual service (via a website or app), collect their own samples, return test samples to a laboratory, and be notified of their results by short message service (SMS) or telephone. e-STI testing is assumed to increase access to testing in comparison with face-to-face services, but the evidence is unclear. We conducted a randomised controlled trial to assess the effectiveness of an e-STI testing and results service (chlamydia, gonorrhoea, HIV, and syphilis) on STI testing uptake and STI cases diagnosed.

Keywords

Sexually transmitted diseases; Chlamydia; HIV diagnosis and management; Syphilis; HIV; Internet; Chlamydia infection; Men who have sex with men

Item Type Dataset
Resource Type
Resource Type
Resource Description
Dataset
UNSPECIFIED
Description of data capture The study took place in the London boroughs of Lambeth and Southwark. Between 24 November 2014 and 31 August 2015, we recruited 2,072 participants, aged 16–30 years, who were resident in these boroughs, had at least 1 sexual partner in the last 12 months, stated willingness to take an STI test, and had access to the internet. Those unable to provide consent and unable to read English were excluded. Participants were randomly allocated to receive 1 text message with the web link of an e-STI testing and results service (intervention group) or to receive 1 text message with the web link of a bespoke website listing the locations, contact details, and websites of 7 local sexual health clinics (control group). Participants were free to use any other services or interventions during the study period. The primary outcomes were self-reported STI testing at 6 weeks, verified by patient record checks, and self-reported STI diagnosis at 6 weeks, verified by patient record checks. Secondary outcomes were the proportion of participants prescribed treatment for an STI, time from randomisation to completion of an STI test, and time from randomisation to treatment of an STI. Participants were sent a £10 cash incentive on submission of self-reported data. We completed all follow-up, including patient record checks, by 17 June 2016. Uptake of STI testing was increased in the intervention group at 6 weeks (50.0% versus 26.6%, relative risk [RR] 1.87, 95% CI 1.63 to 2.15, P < 0.001). The proportion of participants diagnosed was 2.8% in the intervention group versus 1.4% in the control group (RR 2.10, 95% CI 0.94 to 4.70, P = 0.079). No evidence of heterogeneity was observed for any of the pre-specified subgroup analyses. The proportion of participants treated was 1.1% in the intervention group versus 0.7% in the control group (RR 1.72, 95% CI 0.71 to 4.16, P = 0.231). Time to test, was shorter in the intervention group compared to the control group (28.8 days versus 36.5 days, P < 0.001, test for difference in restricted mean survival time [RMST]), but no differences were observed for time to treatment (83.2 days versus 83.5 days, P = 0.51, test for difference in RMST). We were unable to recruit the planned 3,000 participants and therefore lacked power for the analyses of STI diagnoses and STI cases treated.
Capture method Questionnaire: Fixed form - Web-based, Experiment
Date 27 December 2017
Geographical area covered (offline during plugin upgrade)
North Latitude
East Longitude
South Latitude
West Longitude
51.4892
-0.0773052
51.484
-0.0886348
51.4605
-0.121362
51.4575
-0.12634
Language(s) of written materials English
Creator(s) Wilson, E; Free, C; Morris, TP; Syred, J; Ahamed, I; Menon-Johansson, AS; Palmer, MJ; Barnard, S; Rezel, E and Baraitser, P
LSHTM Faculty/Department Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Participating Institutions London School of Hygiene & Tropical Medicine, London, United Kingdom
Funders
Project
Funder
Grant Number
Funder URI
Can internet-based sexual health services increase diagnoses of sexually transmitted infections (STIs)? Evaluation of an internet-based sexual health service
Guy's and St Thomas' Charity
UNSPECIFIED
UNSPECIFIED
Date Deposited 03 Jan 2018 10:34
Last Modified 28 Sep 2018 21:20
Publisher PLOS Medicine

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