Web-Based STI/HIV Testing Services Available for Access in Australia: Systematic Search and Analysis
BackgroundSexually 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 timely access to STI/HIV testing and have proliferated in...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2023-09-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2023/1/e45695 |
| _version_ | 1827808915914489856 |
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| author | Ethan Trey Cardwell Teralynn Ludwick Christopher Fairley Christopher Bourne Shanton Chang Jane S Hocking Fabian Y S Kong |
| author_facet | Ethan Trey Cardwell Teralynn Ludwick Christopher Fairley Christopher Bourne Shanton Chang Jane S Hocking Fabian Y S Kong |
| author_sort | Ethan Trey Cardwell |
| collection | DOAJ |
| description |
BackgroundSexually 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 timely 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 was to systematically identify web-based STI/HIV testing services available in Australia and assess them on aspects of quality, reliability, and accessibility.
ObjectiveWe aim to systematically identify and assess web-based STI/HIV testing services available in Australia.
MethodsA Google search of Australian web-based services was conducted in March 2022 and repeated in September 2022 using Boolean operators and search terms related to test services (eg, on the internet or home), STIs (eg, chlamydia or gonorrhea), and test type (eg, self-test). The first 10 pages were assessed, and services were categorized as self-testing (ST; test at home), self-sampling (SS; sample at home and return to laboratory), or self-navigated pathology (SNP; specimens collected at pathology center). Website reliability was assessed against the Health on the Net Foundation code of conduct, and service quality was assessed using a scorecard that was developed based on similar reviews, Australian guidelines for in-person services, and UK standards. Additionally, we looked at measures of accessibility including cost, rural access, and time to test results.
ResultsSeventeen services were identified (8 ST, 2 SS, and 7 SNP). Only 4 services offered recommended testing for all 4 infections (chlamydia, gonorrhea, syphilis, and HIV) including genital, anorectal, and oropharyngeal sites, and 5 offered tests other than those recommended by Australian testing guidelines (eg, Ureaplasma). Nine services (1 SNP, 8 self-test) had no minimum age requirements for access. Reliability scores (scale 0-8) were similar between all services (range 4.75-8.0). Quality weighted scores (scale 0-58) were similar between SNP and SS services (average 44.89, SD 5.56 and 44.75, SD 1.77, respectively) but lower for ST services (22.66, SD 8.93; P=.002). Government-funded services were of higher quality than private services (43.54, SD 6.71 vs 29.43, SD 13.55; P=.03). The cost for services varied between SNP (Aus $0-$595; ie, US $0-$381.96), self-sample (Aus $0; ie, US $0), and ST (Aus $0-$135; ie, US $0-$86.66). The time to test results was much shorter for SNP services (~4 days) than for SS (~12 days) and ST (~14 days).
ConclusionsThis review identified considerable variability in the quality and reliability of the web-based STI/HIV testing services in Australia. Given the proliferation and use of these services will likely increase, 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 inappropriate tests. |
| first_indexed | 2024-03-11T22:35:31Z |
| format | Article |
| id | doaj.art-0d97f1c4019a4d6e9ea4e2bc717402c5 |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-11T22:35:31Z |
| publishDate | 2023-09-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-0d97f1c4019a4d6e9ea4e2bc717402c52023-09-22T14:31:33ZengJMIR PublicationsJournal of Medical Internet Research1438-88712023-09-0125e4569510.2196/45695Web-Based STI/HIV Testing Services Available for Access in Australia: Systematic Search and AnalysisEthan Trey Cardwellhttps://orcid.org/0009-0000-8446-7940Teralynn Ludwickhttps://orcid.org/0000-0003-4160-7354Christopher Fairleyhttps://orcid.org/0000-0001-9081-1664Christopher Bournehttps://orcid.org/0000-0001-7391-3941Shanton Changhttps://orcid.org/0000-0002-2163-3910Jane S Hockinghttps://orcid.org/0000-0001-9329-8501Fabian Y S Konghttps://orcid.org/0000-0002-9349-3080 BackgroundSexually 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 timely 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 was to systematically identify web-based STI/HIV testing services available in Australia and assess them on aspects of quality, reliability, and accessibility. ObjectiveWe aim to systematically identify and assess web-based STI/HIV testing services available in Australia. MethodsA Google search of Australian web-based services was conducted in March 2022 and repeated in September 2022 using Boolean operators and search terms related to test services (eg, on the internet or home), STIs (eg, chlamydia or gonorrhea), and test type (eg, self-test). The first 10 pages were assessed, and services were categorized as self-testing (ST; test at home), self-sampling (SS; sample at home and return to laboratory), or self-navigated pathology (SNP; specimens collected at pathology center). Website reliability was assessed against the Health on the Net Foundation code of conduct, and service quality was assessed using a scorecard that was developed based on similar reviews, Australian guidelines for in-person services, and UK standards. Additionally, we looked at measures of accessibility including cost, rural access, and time to test results. ResultsSeventeen services were identified (8 ST, 2 SS, and 7 SNP). Only 4 services offered recommended testing for all 4 infections (chlamydia, gonorrhea, syphilis, and HIV) including genital, anorectal, and oropharyngeal sites, and 5 offered tests other than those recommended by Australian testing guidelines (eg, Ureaplasma). Nine services (1 SNP, 8 self-test) had no minimum age requirements for access. Reliability scores (scale 0-8) were similar between all services (range 4.75-8.0). Quality weighted scores (scale 0-58) were similar between SNP and SS services (average 44.89, SD 5.56 and 44.75, SD 1.77, respectively) but lower for ST services (22.66, SD 8.93; P=.002). Government-funded services were of higher quality than private services (43.54, SD 6.71 vs 29.43, SD 13.55; P=.03). The cost for services varied between SNP (Aus $0-$595; ie, US $0-$381.96), self-sample (Aus $0; ie, US $0), and ST (Aus $0-$135; ie, US $0-$86.66). The time to test results was much shorter for SNP services (~4 days) than for SS (~12 days) and ST (~14 days). ConclusionsThis review identified considerable variability in the quality and reliability of the web-based STI/HIV testing services in Australia. Given the proliferation and use of these services will likely increase, 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 inappropriate tests.https://www.jmir.org/2023/1/e45695 |
| spellingShingle | Ethan Trey Cardwell Teralynn Ludwick Christopher Fairley Christopher Bourne Shanton Chang Jane S Hocking Fabian Y S Kong Web-Based STI/HIV Testing Services Available for Access in Australia: Systematic Search and Analysis Journal of Medical Internet Research |
| title | Web-Based STI/HIV Testing Services Available for Access in Australia: Systematic Search and Analysis |
| title_full | Web-Based STI/HIV Testing Services Available for Access in Australia: Systematic Search and Analysis |
| title_fullStr | Web-Based STI/HIV Testing Services Available for Access in Australia: Systematic Search and Analysis |
| title_full_unstemmed | Web-Based STI/HIV Testing Services Available for Access in Australia: Systematic Search and Analysis |
| title_short | Web-Based STI/HIV Testing Services Available for Access in Australia: Systematic Search and Analysis |
| title_sort | web based sti hiv testing services available for access in australia systematic search and analysis |
| url | https://www.jmir.org/2023/1/e45695 |
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