Online chlamydia testing: an innovative approach that appeals to young people

Kwan, Kellie S.H.; Jachimowicz, Edwina A; Bastian, Lisa; Marshall, Lewis; Mak, Donna B

doi:10.5694/mja11.11517

Cited by 15 publications

(32 citation statements)

References 16 publications

(25 reference statements)

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“…The evidence of the impact of Internet-based testing programs is beginning to accumulate, primarily for population-based chlamydia screening programs [8,12,13]. However, substantial knowledge gaps remain regarding the impact of these services at a population level, such as the reach and diffusion of programs within populations at higher risk for STI/HIV [14].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Intention to Use Internet-Based Testing for Sexually Transmitted Infections Among Men Who Have Sex With Men

Gilbert¹,

Salway²,

Kerr³

et al. 2013

J Med Internet Res

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BackgroundInternet-based testing programs are being increasingly used to reduce testing barriers for individuals at higher risk of infection, yet the population impact and potential for exacerbation of existing health inequities of these programs are not well understood.ObjectiveWe used a large online sample of men who have sex with men (MSM) in Canada to measure acceptability of Internet-based testing and perceived advantages and disadvantages of this testing approach.MethodsWe asked participants of the 2011/2012 Sex Now Survey (a serial online survey of gay and bisexual men in Canada) whether they intended to use Internet-based testing and their perceived benefits and disadvantages of use. We examined whether intention to use was associated with explanatory variables spanning (A) sociodemographics, (B) Internet and technology usage, (C) sexually transmitted infections (STI)/ human immunodeficiency virus (HIV) and risk, and (D) health care access and testing, using multivariable logistic regression (variable selection using Bayesian information criterion).ResultsOverall, intention to use was high (5678/7938, 71.53%) among participants with little variation by participant characteristics. In our final model, we retained the variables related to (B) Internet and technology usage: use of Internet to cruise for sex partners (adjusted odds ratio [AOR] 1.46, 95% CI 1.25-1.70), use of Internet to search for sexual health information (AOR 1.36, 95% CI 1.23-1.51), and mobile phone usage (AOR 1.19, 95% 1.13-1.24). We also retained the variables for (D) health care access and testing: not “out” to primary care provider (AOR 1.24, 95% CI 1.10-1.41), delayed/avoided testing due to privacy concerns (AOR 1.77, 95% CI 1.49-2.11), and delayed/avoided testing due to access issues (AOR 1.65, 95% CI 1.40-1.95). Finally, we retained the variable being HIV positive (AOR 0.56, 95% CI 0.46-0.68) or HIV status unknown (AOR 0.89, 95% CI 0.77-1.01), age <30 years (AOR 1.41, 95% CI 1.22-1.62), and identifying as bisexual (AOR 1.18, 95% CI 1.04-1.34) or straight/other (AOR 0.67, 95% CI 0.50-0.90). The greatest perceived benefits of Internet-based testing were privacy (2249/8388, 26.81%), general convenience (1701/8388, 20.28%), and being able to test at any time (1048/8388, 12.49%). The greatest perceived drawbacks were the inability to see a doctor or nurse (1507/8388, 17.97%), wanting to talk to someone about results (1430/8388, 17.97%), not wanting online results (1084/8388, 12.92%), and low trust (973/8388, 11.60%).ConclusionsThe high and wide-ranging intention to use that we observed suggests Internet-based testing has the potential to reach into all subgroups of MSM and may be particularly appealing to those facing current barriers to accessing STI/HIV testing and who are more comfortable with technology. These findings will be used to inform the promotion and further evaluation of an Internet-based testing program currently under development in British Columbia, Canada.

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Section: Introductionmentioning

confidence: 99%

Factors Associated With Intention to Use Internet-Based Testing for Sexually Transmitted Infections Among Men Who Have Sex With Men

Gilbert¹,

Salway²,

Kerr³

et al. 2013

J Med Internet Res

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“…In relation to uptake of CT screening, nine were judged as having a high impact, three a moderate impact and five a low impact on screening rates . Three of the four interventions that achieved a higher positivity rate included a formal risk assessment for participants as part of their strategy to promote testing in higher risk groups . None of the interventions with lower rates of positive tests included such a formal risk assessment.…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen interventions promoted the use of urine CT tests kits. Three promoted use of vaginal swabs, while one provided urine tests for men and vaginal swab tests for women. Only one intervention (reported in two papers) provided users a choice of vaginal or urine testing …”

Section: Resultsmentioning

confidence: 99%

A review of current practices to increase Chlamydia screening in the community – a consumer‐centred social marketing perspective

Phillipson

Gordon

Telenta

et al. 2015

Health Expectations

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“…They appear to successfully target a younger technology-savvy population and remove the need for a clinician visit or pelvic examination as a barrier to screening [24][25][26][27]. It is important to note that these studies were all supported by public health organizations in their respective countries.…”

Section: Pelvic Examination For Sexually Transmitted Infection Screeningmentioning

confidence: 99%

Should the Annual Pelvic Examination Go the Way of Annual Cervical Cytology?

MacLaughlin

Faubion

Long

et al. 2014

Womens Health (Lond Engl)

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sey theThe value of pelvic examination for healthy asymptomatic women has been called into question given the lack of benefit for ovarian and endometrial cancer screening, the ability to screen for sexually transmitted infections without a pelvic examination, and the uncoupling of the procurement of contraception with a pelvic examination. Still, there are indications for performing pelvic examinations in symptomatic women and in some high risk women. How do we as clinicians apply current evidence and expert opinion to our medical practice? Our recommendation to consider a pelvic examination at 3−5-year intervals with cervical cancer screening to elicit gynecologic and sexual health concerns offers a compromise between continuation of unnecessary annual pelvic examinations and complete elimination of these examinations. Keywords: bimanual • pelvic examination • screening • speculum examination BackgroundPelvic examination indications for healthy asymptomatic women have encompassed such preventive services as screening for cancer and infection. They have been associated with contraception counseling, evaluation and initiation. In previous years, pelvic examinations were performed annually for women in conjunction with cervical cancer screening, regardless of medical history or symptoms. In the past decade, cervical cancer screening guidelines have changed significantly favoring less frequent screening for most women. The most recent national guideline updates from the USA recommend cervical cytology every 3 years for women aged 21 years and older and include the option of 5-year cervical cytology/high-risk HPV co-testing for women 30-65 years old [1][2][3]. This has resulted in a major change in healthcare visit frequency. Women no longer need to schedule annual appointments for cervical cancer screening. Healthcare providers and researchers appropriately question the value of the annual pelvic examination for healthy asymptomatic women, its relationship to other gynecologic and preventive healthcare, and seek guidance regarding counseling patients. Herein, we will review traditional indications for pelvic examinations and review evidence and best practices from the USA and around the world. We will provide our perspective on answering the question: 'Should the annual pelvic examination go the way of annual cervical cytology?' What does a pelvic examination include?A comprehensive pelvic examination entails more than cervical cancer screening. It generally includes visualization of the external genitalia, a speculum examination of the vaginal and cervix, a bimanual examination of the uterus and adnexal areas, and a rectovaginal examination. The examination may include collection of cervical cytology (with or without HPV testing) for cervical cancer screening and endocervical or vaginal specimens to evaluate for infection. Pelvic examinations have commonly been performed for screening, symptom assessment and surveillance [4].Should the annual pelvic examination go the way of annual cervical cytology? Kathy Pelv...

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Online chlamydia testing: an innovative approach that appeals to young people

Abstract: Internet-based screening for chlamydia is an effective means of increasing access to testing for young people at risk of sexually transmitted infections and is a valuable addition to opportunistic, clinic-based strategies.

Cited by 15 publications

References 16 publications

Factors Associated With Intention to Use Internet-Based Testing for Sexually Transmitted Infections Among Men Who Have Sex With Men

Factors Associated With Intention to Use Internet-Based Testing for Sexually Transmitted Infections Among Men Who Have Sex With Men

A review of current practices to increase Chlamydia screening in the community – a consumer‐centred social marketing perspective

Should the Annual Pelvic Examination Go the Way of Annual Cervical Cytology?

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