Online testing over samples population groups with the greatest STI risk

18th July 2023 by Claire Taylor

Lesley Navaratne,2 Mark Clune,1 John White,1 Anatole Menon-Johansson1 and Efejiro Ashano1

1Preventx, 2Maidstone and Tunbridge Wells NHS Trust

Background

Online postal self-sampling services provide home sampling kits for Chlamydia, Gonorrhoea, Trichomonas, HIV, Syphilis, Hepatitis B & C tests and they have been shown to improve access to testing. In the UK, Sexually Transmitted Infections (STIs) are disproportionally high among young people, Black and Minority Ethnic Groups, Men who have Sex with Men (MSM) and communities of relative poverty; however, it is not known whether these ‘at risk’ groups engage with online services.

We therefore investigated how the demographics of online users compared to the local population.

Methods

The demographics of clients who completed online STI orders between April 4th, 2021 and March 21, 2022, were obtained from the online postal self sampling service serving a county in Southeast England with a population of 1,589,100 in 2020. The proportion of online clients by each demographic were compared with the proportions of the county provided by the UK Office of National Statistics. The Index of Multiple Deprivation (IMD) is an aggregate score of seven domains that include income, employment, education, health, crime, barriers to housing & services and the living environment. IMD is divided into deciles, with decile 1 representing those living in highest levels of deprivation and decile 10 those living with least deprivation.

Results

All the results, summarised in tables 1 to 3, show the number of test orders by demographic category, their proportion, the known demographic proportion for the county and the difference. Online testing clients were more likely to be younger, Black African, and living in areas with the lowest deciles of deprivation (most deprived). Men were significantly under sampled; however, of the men who tested, 21% were MSM.

Conclusion

In this analysis of service users of an online postal self-sampling service for STI testing we have demonstrated an over-representation by those very groups with the greatest STI risk. Additional work is required to repeat this analysis across other counties and metropolitan areas in England.