Symptom status and postal kit return rates of individuals accessing and online STI testing service

9th June 2022 by Kate Ebbutt

Apea V (Preventx), White J (Preventx), Clune M (Preventx), Goward C (Preventx), Day S (Chelsea & Westminster NHS Foundation Trust)

Background:

Online sexual health services (e-services) are being increasingly used for STI testing. Reduced sexual health clinic capacity due to the Covid-19 pandemic prompted our regional e-service to widen eligibility and enable individuals with mild symptoms to access our service. Prior to placing a kit order, information was shown to all symptomatic service users, advising them of the benefits of attending a sexual health clinic and/ or to attend a clinic if symptoms persist/worsen.

Method:

A retrospective analysis was performed of service users that ordered a testing kit between March 2020, and December 2021. Kit return rates were compared according to symptom status.

Results:

Of 888,619 kit orders 163,023 (18.3%) came from symptomatic users. The most common symptom reported was vaginal discharge (41.1%), followed by dysuria/frequency (18.4%) and itching (13.8%). The kit return rate among asymptomatic service users was significantly higher (79.3%) compared to symptomatic users (74.3%) (X2 6.04. p =0.01401). The highest return rates were seen among individuals with itching (75.8%), dysuria/frequency (75.7%) and vaginal discharge (74.6%). The lowest return rate was seen by individuals with genital lumps (71.2%).

Discussion:

Significantly fewer kits were returned by symptomatic e-service users compared to asymptomatics. It is plausible the e-service advisory information deterred some users from returning kits, encouraging them to instead test at a clinic. However, many users opted to complete testing online or perhaps did so because of difficulty accessing a sexual health clinic. Further work is needed to explore the preferred modality of testing providers and the suitability of online services for symptomatic individuals.