Search

Background. Although there has been growth in online STI testing services, more attention is needed to understand how to facilitate effective treatment pathways for users. This study investigated where young people want to be treated for gonorrhoea and syphilis if they test positive using an online service. Methods. We conducted an online survey of Australians aged 16-29 years that included multiple choice and free-text questions about their preferred location for receiving injectable antibiotics. Multivariable multinomial logistic regression examined associations between respondent characteristics and service preferences. Content analysis was used to code free-text responses. Results. Among 905 survey respondents, 777 (85.9%) answered questions on treatment preferences. Respondents most commonly preferred injectable antibiotics provided by a sexual health clinic (294; 37.8%) or a nurse in a pharmacy (208; 26.8%). Gender/sexually diverse respondents were more likely to select sexual health clinics over general practice (MSM RRR 2.5, 95% CI 1.1-5.7; WSW RRR 2.6, 95% CI 1.1-5.7; trans/non-binary RRR 2.5; 95% CI 1.0-6.0). Older respondents (aged 25-29 years) were more likely to choose all alternatives over general practice, with the reverse found for those who had previously tested. From open-text answers, pharmacies were valued for their convenience, and sexual health clinics for providing non-judgemental, free services by specialists. Conclusions. Differences in treatment preferences by certain groups of young people suggest that different service offerings may influence treatment-seeking outcomes from online STI testing services. [ABSTRACT FROM AUTHOR]

Background: In the context of rising STI notifications and capacity constraints on sexual health clinics, the emergence of online STI testing services and selftesting options can help expand access. Our study aimed to understand young Australian's preferences for online STI testing and treatment services. Methods: We recruited Australians aged 16-29 to an online survey using social media and other networks. We assessed their preferences for being: i) triaged for testing (online questionnaire, telehealth consultation, a hybrid of both); ii) tested for STIs (attend lab for specimen collection, self-sampling using home-kits which are mailed to lab); iii) treated (tablets provided by mail; at pharmacy via e-script, at attended clinic). Multivariable multinomial regression (relative risk ratio [RRR]) assessed sociodemographic factors associated with service preferences. Results: Of 905 individuals, 41% were same sexattracted, 13% trans/non-binary, 24% culturally/linguistically diverse (CALD), and 21% resided rurally. For triage, 42% preferred an online questionnaire, 9% telehealth consultation, and 48% a hybrid approach. Rural versus urban youth preferred online questionnaire compared with telehealth (RRR=1.92; 95%CI 1.04 to 3.55), whereas CALD were less likely to select online (RRR=0.43; 95%CI 0.24 to 0.79). For testing, most preferred homekits for urine (65%) and for swabs (71%), but not bloods (29%). Preference for homekits over pathology labs was positively associated with rural location (RRR=2.45; 95%CI 1.13 to 5.29) and negatively with CALD identity (RRR=0.54; 95%CI 0.30 to -2.06). Increased privacy was the most common reason for selecting homekits, with 86% willing to provide some copayment (median $20, IQR $15-35). For treatment, most preferred to receive an e-script (63%), with only 10% preferring tablets by mail. Compared to clinic-provided treatment, mailed tablets appealed to rural youth (RRR:2.31; 95%CI 1.16 to 4.63) and older youth aged (25-29) (RRR=6.31; 95%CI 2.39 to 16.69), but not trans/non-binary individuals (RRR=0.17; 95%CI 0.05 to 0.61), while CALD individuals (RRR=0.52; 95%CI 0.35 to 0.78) were less likely to choose e-scripts. Conclusion: Our results show significant interest in self-sampling and automated prescriptions. Preferences for online and non-clinic facing options likely reflect different barriers to service use encountered by different populations, and may differentially attract rural youth and CALD individuals. [ABSTRACT FROM AUTHOR]

Background: Sexually transmitted infection (STI) rates continue to rise but in-person testing services are unable to meet these demands resulting in the proliferation of online testing services. However, access to services can be disparate between populations affected by remoteness, stigma or cultural identity. This study aims to explore the preferences of young people from diverse backgrounds on what they prefer from an online STI testing service regarding its language, trustworthiness, and the advertising of these services. Methods: Australians aged 16-29 were recruited via digital media and completed a survey about their online STI testing preferences. Logistic regression was used to determine preference for online vs inperson services from populations including those living in rural areas, culturally and linguistically diverse (CALD), and men who have sex with men (MSM). Descriptive statistics was used to describe preferences of young people regarding trustworthiness, language used by the website, and how it's advertised. Results: 905 people responded to the survey. 46% were cis-gendered heterosexuals, 20% MSM, 24% were CALD with 15% of Asian descent. 21% lived in rural areas. Overall, 75% preferred online testing over in-person testing. Those preferring online services were nearly twice as likely to live in rural areas (OR=1.90, p=.0053). CALD populations (OR=0.58, p=.0042) and those of Asian descent (OR=0.50, 0.0019) were less likely to prefer online testing. Professionally supported (government/clinics) services (98%) and privacy/confidentiality (89%) were selected by most participants as important for a trustworthy service. How to advertise an online STI testing service varied among the populations with new media (e.g. social media) (84%) and collateral materials (eg. posters) (79%) being the top preferences by most people. Participants from rural areas (87%) and of Asian descent (88%) preferred posters as a means of advertising services. Conclusion: These results indicate that there is an overall preference for online STI testing services, but this varies by area of residence and ethnicity. From this study we have a better understanding of how we can develop and advertise a service that is trustworthy and accessible to all. [ABSTRACT FROM AUTHOR]

Background: Sexually transmitted infection (STI) rates continue to rise in Australia and timely access to testing and treatment is crucial to reduce transmission. Web-based services have been viewed as a way to improve access to STI/HIV testing and have proliferated in recent years. However, the regulation of these services in Australia is minimal, leading to concerns about their quality. The purpose of this review was to systematically identify and assess web-based HIV/STI testing services available in Australia. Methods: A Google search of Australian web-based STI testing services was conducted in March 2022 and repeated in September 2022 using Boolean operators including test service terms (e.g., online/home), STI terms (e.g., chlamydia/gonorrhoea) and test-type terms (e.g., self-test). The first 10 webpages were assessed, and services categorized as self-testing (test-at-home), self-sampling (sample at home and return sample to laboratory) or self-navigated pathology (specimens collected at pathology service). Service reliability was assessed against the Health-on-the-Net Foundation Code of Conduct, and quality assessed using a score card we developed based on Australian guidelines. Additional factors were assessed including cost, time till results and rural access. Results: Seventeen services were identified (8 selftesting, 2 self-sampling, 7 self-navigated pathology). Only 4 offered recommended testing for all four infections (chlamydia, gonorrhoea, syphilis, HIV) at appropriate genital, anorectal and oropharyngeal sites. 5 services offered tests not recommended by guidelines (e.g., ureaplasma). 9 services (1 selfnavigated pathology, 8 self-test) had no minimum age requirements for access. Reliability scores (scale 0-8) were similar between all services (range 4.75- 6.0, p=0.115). Quality scores (scale 0-58) were similar between self-navigated pathology and selfsampling services (average 44.89 and 44.75 respectively) but lower for self-testing services (22.66, p=0.002). Cost for services varied between self-navigated pathology ($0-595), self-sample ($0) and self-testing ($0-135). Self-navigated pathology was the fastest way to get results at about four days. Self-testing took the longest at about 14 days. Conclusion: There was considerable variability in quality and reliability of services identified. It is imperative that Australia develops standards to ensure the standard-of-care offered by web-based STI/HIV testing services is appropriate to protect Australian users from the impact of poorly performing and/or inappropriate tests. [ABSTRACT FROM AUTHOR]