Online Sexually Transmitted Infections Research Articles

Variations in sexually transmitted infection self-testing response rates and self-sampling submission rates among men who have sex with men recruited via different approaches: A Multi-Center Observational Study

Objective: Self-collection, self-testing, and telemedicine among high-risk population were important strategies in increase the accessibility of STI services and facilitate their expansion. However, many previous studies have showed that the self-test kit usage and response rates are not high in the MSM population. Different routes of recruitment may affect their response rates. To analyze the differences in response rates of sexually transmitted infection (STI) self-testing and submission rates of self-acquired samples from men who have sex with men recruited through an online platform, STI clinics, and non-governmental organizations (NGOs). Methods: Participants were enrolled in this observational study via three different recruitment methods from July to December 2022. Self-testing kits for human immunodeficiency virus (HIV), Treponema pallidum, and hepatitis C virus, and self-sampling kits for Chlamydia trachomatis and Neisseria gonorrhea were provided to recruited men who have sex with men. The participant’s basic information were collected by using the questionnaire and the resluts of self-testing for HIV/ syphylis and HCV and self-sampling for Chlamydia trachomatis and Neisseria gonorrhea were collected. Multivariate logistic regression analysis was used to identify factors associated with self-test response rate and sample submission rates. Results: A total of 764 participants were recruited from 28 Chinese provinces. In the final analysis data, 670 participants reported their HIV self-testing results, while 644 participants mailed their self-acquired samples to the laboratory. Among the 670 participants, there were 51 patients infected with HIV, 31 infected with syphilis, and 2 infected with the hepatitis C virus. The total prevalences of C. trachomatis and N. gonorrhea were 23.0% (176/637) and 7.6% (58/636), respectively. There were no significantly difference among the willingness of self-test among paticipants recriuted from three rouitines , while the HIV self-test response rate was significantly higher among participants recruited in STI clinics than among participants recruited through the “Aiyijian” platform (adjusted odds ratio [AOR] 0.018, 95% confidence interval [CI] 0.002–0.136) or NGOs (AOR 0.054, 95% CI 0.007 – 0.401). Comparing to the participantd recruited from STI clinics, the willingness of self-sample was significantly higher among participants recruited through the “Aiyijian” platform (AOR 4.557,95% CI 1.445-14.271) and NGO (AOR 2.391, 95% CI 1.136-5.034), but the rectal sample submission rates were significantly lower among participants recruited by the “Aiyijian” platform (AOR 0.014, 95% CI 0.003 – 0.062) or NGOs (AOR 0.062, 95% CI 0.014 – 0.262). Conclusion: MSM recriuted from Aiyijian online paltform and NGO were more willing to self sample, while participants recruited from STI clinics had a greater test result response rate and self-sample submission rate than those recruited via the “Aiyijian” online platform and NGOs. In addition to STI clinics, online platform and NGOs will play a very important role in recommending self-sampling for STIs among MSM population.

Preferences for online or in-person STI testing vary by where a person lives and their cultural background: a survey of young Australians

ObjectivesThe objectives are to explore the acceptability of online sexually transmitted infection (STI) testing services among young Australians (16–29 years) and how this may vary between sociodemographic populations.MethodsA cross-sectional, online...

Comprehensive Evaluation of a Collegiate Sexually Transmitted Infection Brief Online Educational Program

Sexually transmitted infections (STIs) are common and consequential among college students, but few collegiate STI educational interventions have been examined. This study therefore comprehensively evaluated a brief online STI educational program for college students. Pre- and post-test surveys gathered formative and summative data (N = 304). The intervention effectively increased participants’ STI knowledge (p<.001), although some gaps persisted. Students were receptive to the program; they valued the informativeness, animated content, specific information, presentation delivery, and clarity, and provided some suggestions for improvement. Brief online STI educational programs are recommended for college students alongside additional sexuality education initiatives to enhance STI knowledge.

An evaluation of an online STI service across London: reviewing uptake, utility and outcomes over a 4-year period

ObjectivesSince 2018, Sexual Health London (SHL) has provided remote sexually transmitted infection (STI) testing services to London residents over 16 years of age. SHL was an asymptomatic screening service. In...

Factors Associated With New Sexual Partnerships During the COVID-19 Pandemic: A Survey of Online Sexually Transmitted Infection Testing Platform Users.

The COVID-19 pandemic has coincided with an explosion of online platforms for sexually transmitted infections (STIs) testing using self-collected, mail-in specimens. Reports on the effect of COVID-19-associated restrictions on sexual behaviors have been mixed, but STI transmissions have continued during the pandemic. We sought to understand the pandemic impact on sexual habits associated with STIs among IWantTheKit users. Users of IWantTheKit, a free, online STI testing platform, were invited to complete an anonymous questionnaire. Descriptive statistics were used to describe survey responses. Associations with reports of new sex partnerships were explored as a marker of STI risk. Descriptive statistics, univariate and multivariate logistic regression models were used to analyze individual characteristics and reported behaviors associated with self-reported new sexual partnerships during the first 2 COVID-19 pandemic waves. Of the 3462 users of the online STI testing platform between June 2020 and February 2021, 1088 (31.4%) completed the online survey; 705 (66.2%) of 1065 reported a new sex partner. One-quarter met their sex partners using apps. Overall, 10% were symptomatic and almost 18% were concerned that their partner had an STI. White race in men (odds ratio, 1.81; 95% confidence interval, 1.04-3.16), women younger than 25 years (odds ratio, 1.85; 95% confidence interval, 1.09-3.14), and increased condom use in both men and women were significantly associated with reports of new sexual partnerships in adjusted analysis. Despite pandemic restrictions on social gatherings, new sexual partnerships were common in this population, associated with common risk factors, and may help to explain ongoing STI transmission.

Factors Associated With Online Sex Partners Among Gay, Bisexual and Other Men Who Have Sex With Men: Results From a National Survey.

Associations between online sex seeking and increased risk for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) among men who have sex with men (MSM) typically rely on convenience samples. We examined Internet and mobile app use for finding sex partners among a nationally representative sample of MSM. We analyzed 2011 to 2017 data from the National Survey of Family Growth, a nationally representative sample of the civilian, non-institutionalized US population (15-44 years). The analytic sample was comprised of men who reported 1 or more same-sex partners in the past year. We also assessed associations between online sex-seeking and STI risk, sexual health care behaviors, and condom use. Of 13,320 male respondents, 442 (3.0%) reported sex with a man in the past year, of whom 215 (46.3%) had met a partner online. Between MSM who met partners online and those who did not, we found no differences by age, education, race/ethnicity or socioeconomic status. Men who have sex with men with online partners were more likely to identify as gay (68.4% vs 49.5%, P = 0.0124). They also reported more sex partners overall (M = 3.04 vs 1.60, P < 0.0001), and multiple insertive (46.3% vs 8.5%, P < 0.0001) and receptive (33.2% vs 15.4%, P = 0.0055) anal sex partners, in the past year. They were also more likely to receive sexual risk assessments (56.0% vs 40.4%, P = 0.0129), STI testing (57.4% vs 35.3%, P = 0.0002), and STI treatment (17.8% vs 8.7%, P = 0.0152) in the past year. We found no differences in condom use. Men who have sex with men who report using online sources to find sex partners are more likely than other MSM to report behaviors that increase risk for STI/HIV but are also more likely to engage in behaviors that may mitigate further transmission, such as STI testing.

Home-Based Testing for Sexually Transmitted Infections: Leveraging Online Resources During the COVID-19 Pandemic.

Home-Based Testing for Sexually Transmitted Infections: Leveraging Online Resources During the COVID-19 Pandemic.

Latent Profiles of Social Media Users, STI Knowledge, and Condom Use among African American Young Adults

The abundance of social networking platforms has increased the frequency and the availability for which individuals communicate with one another. The feasibility and accessibility to go online to find sexual partners pose opportunity for contracting sexually transmitted infections (STI) in the absence of safe sexual practices. Low condom use has been reported among young adults who seek sexual partners online. African American young adults have some of the highest rates of infection for certain STIs. In order to mitigate the incidence and prevalence of STIs in at-risk populations, sexually active young adults must use condoms consistently and correctly during sexual activities. The present study sought to uncover the heterogeneity within African American young adults regarding their online networking utilization, STI knowledge, and sexual risk behavior. African American young adults (N = 236), ages 18 - 23, completed private online survey administration. Using latent class analysis, three classes were identified: Social Network Communicators (43%; N = 101), Social Networking Daters (36%; N = 83), and Media Sharers (21%; N = 52). Social Networking Daters exhibited the highest probability of using online dating sites daily, low STI knowledge, and a zero probability of consistent condom use. All three groups exhibited relatively low STI knowledge. Furthermore, having a history of STI increased the likelihood of being classified into the Social Networking Daters class relative to the other classes. Findings highlight the need to capitalize upon online platforms for African American young adults who utilize online dating sites and other online environments.

Online STI information seeking behaviour and condom use intentions among young Facebook users in Malaysia.

The Internet has opened pathways for youth to find sexual health information which was not easily available to them in the past. Studies have shown that seeking sexual health information online may potentially influence an individuals' decision-making to change their sexual health behaviours. However, there is a gap in research on the associations of seeking online sexually transmitted infection (STI) information with STI prevention among young people, particularly in Malaysia. This study investigated the associations of seeking STI information online with the intentions of condom use among young adult online users in Malaysia. A cross-sectional online survey was conducted among Malaysian youth aged 18-25 years old who were recruited through Facebook. In total, 1530 respondents completed the survey, identifying 874 respondents who had sought STI information online. The majority of respondents had intentions to use condoms as protection against STI. Respondents who sought online STI information were significantly more likely to have the intention to use condoms compared to respondents who did not seek online STI information (OR = 1.33, 95% CI = 1.01-1.76, p = 0.040). Online STI information has the potential to increase access to STI information among young online users in Malaysia amid the stigma surrounding sex-related issues. Providing accurate STI information online from reliable sources may equip young people who have Internet access with awareness of sexual health protective behaviours such as condom use. It is recommended to facilitate Internet access to reach sectors of the population that currently do not have access, as the Internet is useful in STI prevention.

Linking young men who have sex with men (YMSM) to STI physicians: a nationwide cross-sectional survey in China

BackgroundMany young men who have sex with men (YMSM) are reluctant to seek health services and trust local physicians. Online information seeking may encourage YMSM to identify and see trustworthy physicians, obtain sexual health services, and obtain testing for sexually transmitted infections (STIs). This study examined online STI information seeking behaviors among Chinese YMSM and its association with offline physician visits.MethodsWe conducted a nationwide online survey among YMSM through WeChat, the largest social media platform in China. We collected information on individual demographics, sexual behaviors, online STI information seeking, offline STI testing, and STI physician visits. We examined the most commonly used platforms (search engines, governmental websites, counseling websites, generic social media, gay mobile apps, and mobile medical apps) and their trustworthiness. We assessed interest and willingness to use an MSM-friendly physician finder function embedded within a gay mobile app. Logistic regression models were used to examine the correlation between online STI information searching and offline physician visits.ResultsA total of 503 men completed the survey. Most men (425/503, 84.5%) searched for STI information online. The most commonly used platform to obtain STI information were search engines (402/425, 94.5%), followed by gay mobile apps (201/425, 47.3%). Men reported high trustworthiness of information received from gay mobile apps. Men also reported high interest (465/503, 92.4%) and willingness (463/503, 92.0%) to use a MSM-friendly physician finder function within such apps. Both using general social media (aOR =1.14, 95%CI: 1.04–1.26) and mobile medical apps (aOR =1.16, 95%CI: 1.01–1.34) for online information seeking were associated with visiting a physician.ConclusionOnline STI information seeking is common and correlated with visiting a physician among YMSM. Cultivating partnerships with the emerging mobile medical apps may be useful for disseminating STI information and providing better physician services to YMSM.

P102 Integration of clinic services with online sexually transmitted infection (STI) testing (sh:24) in camberwell, se london: impact of active referral of asymptomatic testing online in 2016

IntroductionAn online service was implemented in an area with high burden of sexually transmitted infections and poor sexual health outcomes. The aim was to improve access and availability of sexual health, fully integrated within NHS services. This study looks at the impact of a change in management, whereby asymptomatic patients seeking STI testing in the GUM clinic were directed to the online service.MethodsWe compared clinic attendance in 2016 before (quarter 2, Q2) and after (quarter 3, Q3) the change in clinical practice. Individual level clinic attendance data were collated and summarised as simple STI test performed (chlamydia, gonorrhoea, HIV, syphilis) or complex service required. We also compared service use by age, ethnicity and sexual orientation. Changes in pattern of clinic attendance between the quarters were analysed using a Chi2test.ResultsAbstract P102 Table 1Changing pattern of GUM clinic use.Q2 (Before)Q3 (After)Total visits (valid code)6,9495,397Simple STI test4,044 (58%)2,823 (52%)Complex service4,785 (69%)4,083 (76%)Complex service &amp; simple STI test2,8452,170There were significantly fewer simple STI tests (Chi-squared, p&lt;0.001) and more visits requiring complex services (p&lt;0.001) in Q3 versus Q2.DiscussionFollowing establishment of efficient online STI testing, the clinic changed its triage practice: asymptomatic patients seeking STI testing were directed to use the online service. The change appears to facilitate a higher proportion of more complex visits although the absolute number of visits has decreased.

P110 Working smarter by incorporating online testing: maximising self-management or opening an additional channel? a twelve month review

IntroductionWe reviewed how the introduction of online access to sexually transmitted infection (STI) testing for a county wide sexual health service has affected face to face (F2F) attendances, and overall attendance numbers.MethodsAs part of managing a large county wide integrated-sexual health service we have based our planned attendance numbers on actual activity data from previous years to forecast service activity. In April 2016 we introduced the option of online STI access alongside a complementing triage system. Using electronic record and online access data we compared actual to projected activity, and established the effect of the online service in terms of overall activity for 2016/17.ResultsThe introduction of an online channel together with a reviewed triage system appears to have directly reduced F2F attendances. The overall activity level including both F2F and online for the service did rise, but based on the cost of F2F attendance compared with theaverage cost of online tests, there are still estimated savings of over £500,000 and predicted reduction of around 10,000 F2F attendances.Abstract P110 Table 1F2F and Online testingServiceActivity plan 2016–17Activity actual 2016–17 (based on quarters 2 and 3 extrapolated)F2F5941049398Online access465417118Total6406466516DiscussionPeople have been satisfied with the online service and it appears to be an acceptable and popular alternative and not and addition to F2F. The reduction in F2F attendances (10,000) frees up clinical time enabling improved and increased resource for complex care and staff and service development.

Addendum to: Can Internet-Based Sexual Health Services Increase Diagnoses of Sexually Transmitted Infections (STI)? Protocol for a Randomized Evaluation of an Internet-Based STI Testing and Results Service.

Background: Ensuring rapid access to high quality sexual health services is a key public health objective, both in the United Kingdom and internationally. Internet-based testing services for sexually transmitted infections (STIs) are considered to be a promising way to achieve this goal. This study will evaluate a nascent online STI testing and results service in South East London, delivered alongside standard face-to-face STI testing services.

Can Internet-Based Sexual Health Services Increase Diagnoses of Sexually Transmitted Infections (STI)? Protocol for a Randomized Evaluation of an Internet-Based STI Testing and Results Service.

BackgroundEnsuring rapid access to high quality sexual health services is a key public health objective, both in the United Kingdom and internationally. Internet-based testing services for sexually transmitted infections (STIs) are considered to be a promising way to achieve this goal. This study will evaluate a nascent online STI testing and results service in South East London, delivered alongside standard face-to-face STI testing services.ObjectiveThe aim of this study is to establish whether an online testing and results services can (1) increase diagnoses of STIs and (2) increase uptake of STI testing, when delivered alongside standard face-to-face STI testing services.MethodsThis is a single-blind randomized controlled trial. We will recruit 3000 participants who meet the following eligibility criteria: 16-30 years of age, resident in the London boroughs of Lambeth and Southwark, having at least one sexual partner in the last 12 months, having access to the Internet and willing to take an STI test. People unable to provide informed consent and unable to read and understand English (the websites will be in English) will be excluded. Baseline data will be collected at enrolment. This includes participant contact details, demographic data (date of birth, gender, ethnicity, and sexual orientation), and sexual health behaviors (last STI test, service used at last STI test and number of sexual partners in the last 12 months). Once enrolled, participants will be randomly allocated either (1) to an online STI testing and results service (Sexual Health 24) offering postal self-administered STI kits for chlamydia, gonorrhoea, syphilis, and HIV; results via text message (short message service, SMS), except positive results for HIV, which will be delivered by phone; and direct referrals to local clinics for treatment or (2) to a conventional sexual health information website with signposting to local clinic-based sexual health services. Participants will be free to use any other interventions or services during the trial period. At 6 weeks from randomization we will collect self-reported follow-up data on service use, STI tests and results, treatment prescribed, and acceptability of STI testing services. We will also collect objective data from participating STI testing services on uptake of STI testing, STI diagnoses and treatment. We hypothesise that uptake of STI testing and STI diagnoses will be higher in the intervention arm. Our hypothesis is based on the assumption that the intervention is less time-consuming, more convenient, more private, and incur less stigma and embarrassment than face-to-face STI testing pathways. The primary outcome measure is diagnosis of any STI at 6 weeks from randomization and our co-primary outcome is completion of any STI test at 6 weeks from randomization. We define completion of a test, as samples returned, processed, and results delivered to the intervention and/or clinic settings. We will use risk ratios to calculate the effect of the intervention on our primary outcomes with 95% confidence intervals. All analyses will be based on the intention-to-treat (ITT) principle.ResultsThis study is funded by Guy’s and St Thomas’ Charity and it has received ethical approval from NRES Committee London-Camberwell St Giles (Ref 14/LO/1477). Research and Development approval has been obtained from Kings College Hospital NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust. Results are expected in June 2016.ConclusionsThis study will provide evidence on the effectiveness of an online STI testing and results service in South East London. Our findings may also be generalizable to similar populations in the United Kingdom.Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 13354298; http://www.isrctn.com/ISRCTN13354298 (Archived by WebCite at http://www.webcitation.org/6d9xT2bPj)

Use of a risk quiz to predict infection for sexually transmitted infections: a retrospective analysis of acceptability and positivity

BackgroundIndividuals who are sexually active may want to make a decision as to whether they are at risk for having a sexually transmitted infection (STI) such as Chlamydia trachomatis, Neisseria...

Improving sexual healthcare in general practice

Objective: Describe how different types of resources are received and perceived by primary care clinicians to improve sexual healthcare. Study design: Cross-sectional online survey of primary care clinicians in New South Wales, Australia, to evaluate the perceived impact of nine resources to promote sexual healthcare—seven were tailored to general practitioners (GPs) and two to practice nurses (PNs). Participants: 431 primary care clinicians (GPs=214; PNs=217). Main outcome measures: Awareness, use and perceived impact of the resources. Principal findings: Most GPs were aware of and used the Sexually Transmitted Infections (STI) Testing Tool; the Online STI Testing Tool GP training was perceived to improve GPs' ability to raise the topic of STIs with patients and order appropriate tests. Although the highest proportion of PNs were aware of the online STI PN training, most used the PN Postcard. The former helped to improve PNs' ability to identify at-risk patients and document sexual history. Conclusions: This study supports the need for a multimodal approach to improve the delivery of sexual healthcare in general practice. This would involve the communication of similar messages in different modes, via different channels, at different times.

HIV and sexually transmitted infection prevention online: Current state and future prospects

Over the past decade, research and program efforts have sought to exploit the online presence of people at risk for sexually transmitted infections (STIs) and HIV to develop Internet-based interventions to reduce STI and HIV transmission risk. This study aimed to develop a typology of online STI and HIV interventions to guide implementation in public health practice. Online interventions were identified through web and literature searches and a review of abstracts from STI and HIV prevention conferences. Three categories of interventions were identified: (a) enhancing use of STI and HIV testing, (b) increasing partner notification and treatment, and (c) inducing behavior change to prevent STI and HIV transmission. Many interventions are still in development; little information on their effectiveness and performance exists outside the research setting. Thus, the proper place and priority of online interventions in the spectrum of public health prevention efforts has yet to be determined.