I came across an interesting paper that offered STI testing over the internet rather than at clinics. Published in PLOS Medicine, this trial was a randomized, single-blind, controlled trial. The study was conducted in the UK, and recruited patients between the ages of 16-30 who had at least 1 sexual partner in the past year and had the willingness to undergo testing for STIs. They ended up with a little over 2,000 patients. Patients were randomized to receive either a text message with a link to e-STI services or a text message that linked to a website with locations of many different sexual health clinics. Outcomes that were measured included: self-reported STI testing at 6 weeks (verified by record checks) and self-reported STI diagnosis at 6 weeks (verified by record checks).
The authors found a 50% increase in STI testing in the e-STI group compared to the clinic group. The time to test was shorter in the e-STI group compared to the clinic group and there were no differences for time to treatment.
Personally, I don’t find these results that startling. It makes sense to me why young people would prefer doing the e-STI kit rather than going to a clinic. There are fewer people to deal with, and there’s the sense of feeling completely anonymous. I think that this raises an interesting question on our end: are we doing something wrong in the way we approach patients about STI testing? As physicians, we are to remain objective and non-judgmental about sexual practices and STIs. Perhaps this contributed to the higher use of e-STI kits rather than clinic visits. I’m also curious about how much e-STI kits cost compared to clinic testing. Either way, this may be something we should readily offer to our patients!