Web-Based STI/HIV Testing Services Available for Access in Australia: Systematic Search and Analysis

Sexually transmitted infection (STI) rates continue to rise in Australia, and timely access to testing and treatment is crucial to reduce transmission. Web-based services have been viewed as a way to improve timely access to STI/HIV testing and have proliferated in recent years. However, the regulat...

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Bibliographic Details
Published in:Journal of medical Internet research 2023-09, Vol.25 (1), p.e45695-e45695
Main Authors: Cardwell, Ethan Trey, Ludwick, Teralynn, Fairley, Christopher, Bourne, Christopher, Chang, Shanton, Hocking, Jane S, Kong, Fabian Y S
Format: Article
Language:English
Subjects:
Access
Chlamydia
Chlamydia trachomatis
Codes of conduct
COVID-19
Disease transmission
Gonorrhea
HIV
Human immunodeficiency virus
Inappropriateness
Infections
Internet
Measures
Medical tests
Minimum age
Multimedia
National standards
Operators
Original Paper
Pandemics
Pathology
Privacy
Quality of service
Reliability
Sexual health
Sexually transmitted diseases
STD
Syphilis
Telemedicine
Tests
Web sites
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Summary:Sexually transmitted infection (STI) rates continue to rise in Australia, and timely access to testing and treatment is crucial to reduce transmission. Web-based services have been viewed as a way to improve timely access to STI/HIV testing and have proliferated in recent years. However, the regulation of these services in Australia is minimal, leading to concerns about their quality. The purpose of this review was to systematically identify web-based STI/HIV testing services available in Australia and assess them on aspects of quality, reliability, and accessibility. We aim to systematically identify and assess web-based STI/HIV testing services available in Australia. A Google search of Australian web-based services was conducted in March 2022 and repeated in September 2022 using Boolean operators and search terms related to test services (eg, on the internet or home), STIs (eg, chlamydia or gonorrhea), and test type (eg, self-test). The first 10 pages were assessed, and services were categorized as self-testing (ST; test at home), self-sampling (SS; sample at home and return to laboratory), or self-navigated pathology (SNP; specimens collected at pathology center). Website reliability was assessed against the Health on the Net Foundation code of conduct, and service quality was assessed using a scorecard that was developed based on similar reviews, Australian guidelines for in-person services, and UK standards. Additionally, we looked at measures of accessibility including cost, rural access, and time to test results. Seventeen services were identified (8 ST, 2 SS, and 7 SNP). Only 4 services offered recommended testing for all 4 infections (chlamydia, gonorrhea, syphilis, and HIV) including genital, anorectal, and oropharyngeal sites, and 5 offered tests other than those recommended by Australian testing guidelines (eg, Ureaplasma). Nine services (1 SNP, 8 self-test) had no minimum age requirements for access. Reliability scores (scale 0-8) were similar between all services (range 4.75-8.0). Quality weighted scores (scale 0-58) were similar between SNP and SS services (average 44.89, SD 5.56 and 44.75, SD 1.77, respectively) but lower for ST services (22.66, SD 8.93; P=.002). Government-funded services were of higher quality than private services (43.54, SD 6.71 vs 29.43, SD 13.55; P=.03). The cost for services varied between SNP (Aus $0-$595; ie, US $0-$381.96), self-sample (Aus $0; ie, US $0), and ST (Aus $0-$135; ie, US $0-$86.66). The time to test
ISSN:1438-8871
1439-4456
1438-8871
DOI:10.2196/45695