Sexually transmitted infections (STIs) can wreak havoc on the body. In some cases they cause pain. In others, infertility. And, in extreme cases, they can kill.
Now, a ‘first of its kind’ trial has revealed that the internet could prove incredibly useful in the fight against STIs.
Testing uptake was nearly doubled in a group that was invited to use online STI testing (also known as e-STI testing) compared to a group which was invited to use existing services at health clinics.
STIs remain a global public health concern, with an estimated 357 million new infections of curable STIs (chlamydia, gonorrhoea, syphilis and trichomoniasis) each year.
The randomised controlled trial of more than 2,000 people in Lambeth and Southwark was led by the London School of Hygiene & Tropical Medicine and King’s College London, in partnership with SH:24, a digital sexual health service.
Participants were randomly allocated to receive one of two text messages. The first group was sent a text message with a link listing the locations, contact details and websites of seven local sexual health clinics. The second group received a message linking them to an e-STI testing and results service.
The group given details of the online service was offered postal self-sampling test kits for chlamydia, gonorrhoea, HIV and syphilis, and when returned, were given results via text message or telephone and provided with online information about safe sex and sexual health.
The study found there was 50% uptake in the e-STI testing group compared to 26.6% in the control group.
Researchers suggested that e-STI testing should be considered as a complement to existing services and as an effective measure to increase uptake of STI testing. However, they added that further studies are needed to evaluate the impact of e-STI testing on treatment and health outcomes.
Left undiagnosed and untreated, STIs such as chlamydia and gonorrhoea can increase the risk of HIV transmission and cause a range of health issues including subfertility and ectopic pregnancy. Low rates of HIV testing contribute to late diagnosis and poorer health outcomes.
Study author Caroline Free, from the London School of Hygiene & Tropical Medicine, said: “Sexual health clinics play an important role in community health but some people may find them inconvenient or stigmatising, which can stop them attending.
“Our study showed that when e-STI testing was made available alongside face-to-face services, the number of people getting tested for STIs nearly doubled.”
Participants diagnosed using e-STI testing, and who needed follow-up treatment in clinic, did not have any reduction in treatment time, compared to those who had first attended a face-to-face appointment.
Study author Dr Paula Baraitser, from Kings College London, highlighted the importance of offering both online and face-to-face STI testing.
“Although the intervention group were given information to access an e-STI service, some of them chose to use face-to-face services instead of e-STI testing,” she said.
“Therefore it is important that both online and clinical based services are available to meet the differing needs of people.
“As sexual health services develop we would like to see further work aligning online and clinic based services.”