A recent paper gives details of an Internet-based self-screening programme for Chlamydia in Baltimore, Maryland, running since 2004.\u00a0 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.\u00a0 Participants return a questionnaire with their kit.<\/p>\n
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.\u00a0 Also relevant from this point of view: 1. the overwhelming preference of Internet-based self-screeners for email ordering (86.6%) \u2013 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.<\/p>\n
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.\u00a0 A major concern of the authors is clearly with \u201creaching a population that is different\u201d from family-planning clinic users.\u00a0 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.\u00a0 Whether self-screeners would have accessed services \u2013 or accessed them as early \u2013 without the Internet programme seems hard to gauge \u2013 and there is no discussion of the possible clinical disbenefits of accessing a Chlamydia test outside a clinic setting.<\/p>\n
What this study may demonstrate is that Internet self-screening is a cost-effective way of reaching certain people \u2013 that, in the words of the authors, Internet-based self-screening should be \u201canother tool in our tool box\u201d.<\/p>\n