Comparing the characteristics of users of an online service for STI self-sampling with clinic service users: a cross-sectional analysis

Objectives Online services for self-sampling at homecould improve access to STI testing; however, little isknown about those using this new modality of care.This study describes the characteristics of users of onlineservices and compares them with users of clinic services.Methods We conducted a cross-sectional analysisof routinely collected data on STI testing activity fromonline and clinic sexual health services in Lambeth andSouthwark between 1January 2016 and 31March 2016.Activity was included for chlamydia, gonorrhoea, HIVand syphilis testing for residents of the boroughs aged16 years and older. Logistic regression models wereused to explore potential associations between type ofservice use with age group, gender, ethnic group, sexualorientation, positivity and Index of Multiple Deprivation(IMD) quintiles. We used the same methods to explorepotential associations between return of completesamples for testing with age group, gender, ethnic group,sexual orientation and IMD quintiles among online users.Results 6456 STI tests were carried out by residents inthe boroughs. Of these, 3582 (55.5%) were performedusing clinic services and 2874 (44.5%) using the onlineservice. In multivariate analysis, online users were morelikely than clinic users to be aged between 20 and 30years, female, white British, homosexual or bisexual, testnegative for chlamydia or gonorrhoea and live in lessdeprived areas. Of the individuals that ordered a kit fromthe online service, 72.5% returned sufficient samples.In multivariate analysis, returners were more likely thannon-returners to be aged >20 years and white British.Conclusion  Nearly half (44.5%) of all basic STI testingwas done online, although the characteristics of usersof clinic and online services differed and positivity ratesfor those using the online service for testing were lower.Clinics remain an important point of access for somegroups.