Making home STI tests available online doubles the number of young people getting checked for infections

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Rising rates of infections

STIs remain a global public health concern, with an estimated 357 million new infections of curable STIs, such as chlamydia, gonorrhoea, syphilis and trichomoniasis, each year.

More than 400,000 new diagnoses of infections were made in England in 2015 along with 5,684 new cases of HIV.

In 2016 there were more than 100,000 new STIs diagnosed in London, with residents of the capital accounting for almost half of new HIV diagnoses in the UK in 2015.

Infection is disproportionately high among the under 25s, black minority and ethnic groups and men who have sex with men.

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.

Emma Wilson from the London School of Hygiene & Tropical Medicine and lead author of the study, said: ‘E-STI testing is currently being implemented in the UK as one measure to meet increasing demand for STI testing, but there is surprisingly little evidence on whether it successfully encourages uptake.

‘Our study, the first of its kind, aimed to investigate the effectiveness of e-STI testing for syphilis, HIV, chlamydia and gonorrhoea.’

How the research was carried out 

In the trial participants randomly received one of two text messages.

The control group was sent a text message with a link listing the locations, contact details and websites of seven local sexual health clinics.

The intervention group received a message linking them to the e-STI testing and results service, called SH:24 in the south London boroughs.

The group given details of SH:24 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.

Participants were free to use any other services or interventions during the study period.

Joint senior investigator Caroline Free 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.

‘More long-term monitoring and evaluation of e-STI testing services is needed, but 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.’ 

Importance of e-testing alongside face-to-face services

MALE VIRGINS CAN STILL GET SEXUALLY TRANSMITTED HPV

Male virgins can still get HPV, the first study of its kind found.

Men who have never had intercourse are still at risk of catching the sexually-transmitted human papillomavirus virus (HPV) if they have oral sex.

Study author Dr Alan Nyitray, from The University of Texas in Houston, said: ‘It reinforces the point that HPV vaccination should not be thought of only in the context of sexual behavior.’

HPV is the most common STI in the US and can cause cancer of the penis in men, while women are at risk of developing the condition in the vulva, vagina or cervix.

The infection can also cause cancer of the anus or throat in both sexes.

Around 79 million people in the US are infected with HPV, which is most commonly spread by vaginal or anal sex. Up to four in five people in the UK develop the infection at some point.

Controversially, some girls report being left wheelchair bound and paralyzed after having the jab, however, global health officials have repeatedly said it is safe.

Researchers found that participants diagnosed using e-STI testing, and who needed follow-up treatment in a clinic, did not have any reduction in treatment time, compared to those who had first attended a face-to-face appointment.

New services such as e-treatment and postal treatment, may help improve treatment rates for people diagnosed with STIs online, experts say.

Joint senior investigator Dr Paula Baraitser from Kings College London, said: ‘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.

‘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.

‘Going forward we advise joint commissioning of these different modalities of care to ensure that users are able to move easily from one to another according to their health care needs, allowing continuity of care.’

The study, which also involved King’s College London, was published in Public Library of Science (PLOS). 

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