School of Population Health and Environmental Sciences, Centre for Global Health and Health Partnerships, King's College London, London, UK.
Faculty of Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Sex Transm Infect. 2018 Aug;94(5):377-383. doi: 10.1136/sextrans-2017-053302. Epub 2018 Feb 7.
OBJECTIVES: Online services for self-sampling at home could improve access to STI testing; however, little is known about those using this new modality of care. This study describes the characteristics of users of online services and compares them with users of clinic services. METHODS: We conducted a cross-sectional analysis of routinely collected data on STI testing activity from online and clinic sexual health services in Lambeth and Southwark between 1January 2016 and 31March 2016. Activity was included for chlamydia, gonorrhoea, HIV and syphilis testing for residents of the boroughs aged 16 years and older. Logistic regression models were used to explore potential associations between type of service use with age group, gender, ethnic group, sexual orientation, positivity and Index of Multiple Deprivation (IMD) quintiles. We used the same methods to explore potential associations between return of complete samples for testing with age group, gender, ethnic group, sexual orientation and IMD quintiles among online users. RESULTS: 6456 STI tests were carried out by residents in the boroughs. Of these, 3582 (55.5%) were performed using clinic services and 2874 (44.5%) using the online service. In multivariate analysis, online users were more likely than clinic users to be aged between 20 and 30 years, female, white British, homosexual or bisexual, test negative for chlamydia or gonorrhoea and live in less deprived areas. Of the individuals that ordered a kit from the online service, 72.5% returned sufficient samples. In multivariate analysis, returners were more likely than non-returners to be aged >20 years and white British. CONCLUSION: Nearly half (44.5%) of all basic STI testing was done online, although the characteristics of users of clinic and online services differed and positivity rates for those using the online service for testing were lower. Clinics remain an important point of access for some groups.
目的:在线自我采样服务可以提高性传播感染检测的可及性;然而,人们对使用这种新的护理模式的人群知之甚少。本研究描述了在线服务使用者的特征,并将其与诊所服务使用者进行了比较。
方法:我们对 2016 年 1 月 1 日至 3 月 31 日期间兰贝斯和南华克地区在线和诊所性健康服务中常规收集的性传播感染检测活动数据进行了横断面分析。该活动包括年龄在 16 岁及以上的居民进行衣原体、淋病、艾滋病毒和梅毒检测。使用逻辑回归模型探讨了使用服务类型与年龄组、性别、族裔、性取向、阳性率和多因素贫困指数(Index of Multiple Deprivation,IMD)五分位数之间的潜在关联。我们还使用相同的方法探讨了在线使用者中完全样本返回进行检测与年龄组、性别、族裔、性取向和 IMD 五分位数之间的潜在关联。
结果:该地区有 6456 例性传播感染检测,其中 3582 例(55.5%)使用诊所服务,2874 例(44.5%)使用在线服务。多变量分析显示,与诊所使用者相比,在线使用者更有可能年龄在 20 至 30 岁之间、女性、白种英国人、同性恋或双性恋、衣原体或淋病检测阴性且居住在较贫困地区。在从在线服务订购检测包的人群中,有 72.5%的人返回了足够的样本。多变量分析显示,返回者比未返回者更有可能年龄大于 20 岁且为白种英国人。
结论:尽管诊所和在线服务使用者的特征不同,且使用在线服务进行检测的阳性率较低,但近一半(44.5%)的基本性传播感染检测是在线完成的。诊所仍然是某些人群获得服务的重要途径。
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