Internet testing for Chlamydia trachomatis in England, 2006 to 2010

Area of Science:

• Public Health
• Sexual Health
• Digital Health Interventions

Background:

• Growing interest in online platforms for the National Chlamydia Screening Programme (NCSP) in England.
• Websites offer a potential avenue to increase access to free chlamydia testing.

Purpose of the Study:

• To describe and evaluate online access to chlamydia testing services within the NCSP.
• To compare characteristics of individuals using online vs. traditional testing services.
• To assess the quality of information and signposting provided by chlamydia testing websites.

Main Methods:

• Analysis of NCSP chlamydia testing data (2006-2010) for 15-24 year olds in England.
• Identification of internet-ordered tests using site codes.
• Comparison of demographic and risk factor profiles of online testers versus those using general practice (GP) or community sexual and reproductive health (SRH) services.
• Evaluation of 58 NCSP-offered and 32 commercial websites for health promotion and clinical signposting.

Main Results:

• Internet testing grew from <1% in 2006 to 6% of NCSP tests in 2010.
• Online testing identified a higher proportion of positive chlamydia results compared to GP testing (7.6% vs 5.6%).
• Online users were more likely to be male, aged 20-24, and report multiple sexual partners.
• Significant variation existed in website quality, health promotion content, and clinical service signposting.

Conclusions:

• Internet testing effectively reaches a higher-risk population, including young men, who are traditionally harder to engage.
• Standardization of websites to national guidelines is crucial for consistent health promotion and clinical referral.
• The fragmented, geographically specific service model of the NCSP is incongruent with the internet's unrestricted nature and may confuse users.