Piloting an integrated online STI testing service in Ireland.
Presenter: Rachael Metrustry, Sexual Health and Crisis Pregnancy Programme, Health Service Executive (HSE)
Other Authors: Justin Harbottle, A. Torm Shaw, Dr Paula Baraitser, SH:24*; Professor Fiona Lyons, Caroline Hurley,
Nicola O’Connell, Sexual Health and Crisis Pregnancy Programme, Health Service Executive
Funder: Government of Ireland Sláintecare Integration Fund and HSE Sexual Health and Crisis Pregnancy Programme
(SHCPP).
Introduction
STI testing access is an important public health response to controlling STIs. Online STI testing can overcome barriers
like user embarrassment and access/capacity difficulties at public STI clinics. In 2019, SHCPP commissioned SH:24 to
pilot free online STI testing, integrated with public STI clinics, in Dublin, Cork and Kerry. In these counties >17 year
olds could order STI kits online from January-May 2021. The evaluation sought to assess the pilot service’s feasibility,
impact, and acceptability.
Method
A mixed-methods approach was taken using descriptive statistics of users; user feedback; laboratory STI testing and
public health reported STIs; pilot outputs and an anonymous online survey of the
Results
• Feasibility: 13,749/14,000 available kits ordered. 75% target for return of STI kits to the laboratory: 67%
achieved. 95% target for informing users of test results within 72 hours of laboratory sample receipt: 97.3%
achieved. In total, 637(8%) reactive results. Pilot chlamydia positivity rate was 5.6% versus 4% (Cork/Kerry),
and 6.5% (Dublin) in public STI clinics and general practice in 2019.
• Impact: 57% of pilot service users (61% of those 20-29 years) never previously used sexual health services.
The pilot added an estimated 33% STI testing capacity.
• Acceptability: 94.7% of users rated the service 4 or 5/5. Sixteen service users described difficulty completing
blood testing. Users found the service easy to use, fast/efficient and 10% commented on its privacy/
anonymity. Clinicians in participating clinics largely found the service to be beneficial.
Discussions
The pilot was found to be feasible, impactful and acceptable, increasing access to testing, diagnosing STIs and
engaging new users in STI testing. Little promotion was needed to drive uptake.
Practical/Social/Research Implications
This evaluation will inform national rollout of online STI testing, integrated with public STI clinics, in 2022.
Contact email: rachael.metrustry@hse.ie
*SH:24 is a free online sexual health service
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