Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 12, 2023
Open Peer Review Period: Jan 12, 2023 - Jan 26, 2023
Date Accepted: Aug 21, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Web-based STI/HIV testing services available for access in Australia: an assessment of their quality and cost
ABSTRACT
Background:
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 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 is to systematically identify and assess web-based HIV/STI testing services available in Australia.
Objective:
To systematically identify and assess web-based HIV/STI testing services available in Australia.
Methods:
A Google search of Australian web-based services conducted in March 2022 and repeated in September 2022 using Boolean operators including test service terms (e.g. online/home), STI terms (e.g. chlamydia/gonorrhoea) and test-type terms (e.g. self-test). The first 10 pages were assessed, and services categorized as self-testing (test at home), self-sampling (sample at home return to laboratory) or self-navigated pathology (specimens collected at pathology centre). Service reliability was assessed against the Health on the Net Foundation Code of Conduct, and quality assessed using a score card developed based on Australian guidelines.
Results:
Seventeen services were identified (8 self-testing, 2 self-sampling,7 self-navigated pathology). Only 4 services offered recommended testing for all four infections (chlamydia, gonorrhoea, syphilis, HIV) including genital, anorectal and oropharyngeal sites, and 5 offered tests not recommended by guidelines. 9 services (1 self-navigated pathology, 8 self-test) had no minimum age requirements for access. Reliability scores (scale 0-8) were similar between all services (range 4.75-6.0). Quality scores (scale 0-58) were similar between self-navigated pathology and self-sampling services (average 44.89 and 44.75 respectively) but lower for self-testing services (22.66). Cost for services varied between self-navigated pathology ($0-595), self-sample ($0) and self-testing ($0-135).
Conclusions:
There was considerable variability in quality and reliability of services identified. It is imperative that Australia develops national standards to ensure the standard-of-care offered by web-based STI/HIV testing services is appropriate to protect Australian users from the impact of poorly performing and/or inappropriate tests.
Citation
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Copyright
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