Chlamydia Internet-based self-screening: ‘another tool in our tool-box’?

A recent paper gives details of an Internet-based self-screening programme for Chlamydia in Baltimore, Maryland, running since 2004.  The web site was advertised on the radio and in free community magazines, and kits made available at community locations, or sent on the Internet or in response to phone request.  Participants return a questionnaire with their kit.

Take-up of the programme seems to have been relatively modest, but consistent over time, with the Internet program accounting for 644 tests in Baltimore, as against 15,645 in family planning, and 526 in the rest of Maryland, as against 152,715 in family planning. This may be relevant to those planning future Internet-based self-screening programmes.  Also relevant from this point of view: 1. the overwhelming preference of Internet-based self-screeners for email ordering (86.6%) – leading to an early discontinuation of the community pick-up sites; 2. the return rate, which has varied from 31% to 43% over the years that the programme has been running.

The paper itself is a study of age-specific prevalence in Internet self-screeners as compared with people screened in family planning. The results show a positivity that is (very approximately) double across age groups for self-screeners. Questionnaire responses corroborate the impression of a high-risk group.  A major concern of the authors is clearly with “reaching a population that is different” from family-planning clinic users.  The prevalence study seems to contribute little to our understanding of this population, and the relevance of its age-specific character is not clear to me.  Whether self-screeners would have accessed services – or accessed them as early – without the Internet programme seems hard to gauge – and there is no discussion of the possible clinical disbenefits of accessing a Chlamydia test outside a clinic setting.

What this study may demonstrate is that Internet self-screening is a cost-effective way of reaching certain people – that, in the words of the authors, Internet-based self-screening should be “another tool in our tool box”.

Charlotte A. Gaydos et al., “Chlamydia trachomatis Age-Specific Prevalence in Women Who Used an Internet-Based Self-screening Program Compared to Women Who Were Screened in Family Planning Clinics”, Sexually Transmitted Diseases, Vol. 8 no. 2, February 2011

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