Do transgender populations use online postal self-sampling services for HIV/STI testing in the UK?

22nd June 2023 by Claire Taylor

Kate Ebbutt1, Efejiro Ashano1, Vanessa Apea1,

1Preventx

Background

There is limited research on sexually transmitted infections (STIs) among transgender populations in the UK, despite evidence of STIs and HIV burden globally. One reason could be the significant barriers trans people face when trying to access appropriate healthcare. Online postal self-sampling services (OPSS) may help address barriers to physical sexual health clinics. We sought to quantify and characterise the transgender people using a pan UK OPSS.

Methods

We conducted a retrospective analysis of individual users who self-identified as trans/ trans male/trans female across a pan UK OPSS from 11th November 2015 to 2nd February 2023. We stratified data by age, gender and ethnicity.

Results

We identified 6170 individual trans OPSS users who had completed at least one test order during the time period. Gender identities captured were trans (n=2427; 36.2%), trans female (n=2219; 33.1%) and trans male (n=2064; 30.8%), with the majority aged 16–24 (60.2%). 57% were of White British ethnicity and the remaining 43% comprised a diverse spread from racially minoritised communities (RMC). The data demonstrated increasing usage year by year with total orders and return rates peaking to 1852 and 71.8%, respectively in 2021 from 11 and 39.5%, respectively in 2015. Trans females were more likely to test positive for an STI (12.3%), with the rate being significantly higher for gonorrhoea. Those from RMC were more likely to test positive for an STI, particularly Latin American and Chinese populations.

Discussion

This is one of the largest cohorts of trans people using OPSS. Based on the 2021 census, 6.4% of trans people in the UK (6170/96000) utilise this OPSS. These data demonstrate OPSS as an important route of access for transpeople that is contributing to removing barriers to sexual health care. Further analysis of STI positivity rates among trans users will help identify those at increased risk to best inform health promotion and prevention interventions.