Internet-based self-sampling for Chlamydia trachomatis testing: a national evaluation in Sweden

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Sexual Health

Background:

• Sweden has offered free internet-based chlamydia trachomatis (CT) testing with at-home self-sampling since 2006.
• This service is integrated within the national public healthcare system.

Purpose of the Study:

• To evaluate the national diagnostic outcomes of the internet-based CT self-sampling service in Sweden.
• To compare the effectiveness and uptake of self-sampling versus clinic-based CT testing.

Main Methods:

• Data on CT testing (self-sampling and clinic-based) were collected from laboratories in 18 of 21 Swedish counties.
• Individual testing patterns for CT were analyzed for the years 2013-2017 in four selected counties.

Main Results:

• The proportion of CT tests using self-sampling rose to 22.0% by 2017, with significant increases particularly among women.
• Self-sampling showed a higher CT detection rate (5.5%) compared to clinic-based testing (5.1%), with similar proportions of positive results in men.
• Men were more likely to use self-sampling exclusively (67%) than women (40%) in a 5-year individual-level analysis.

Conclusions:

• At-home CT self-sampling has seen substantial growth, especially among women.
• The service is equally effective as clinic-based screening for CT detection.
• Self-sampling demonstrates a greater reach among men compared to traditional clinic-based testing.