Acceptability, uptake and impact of online home-sampling for STIs in Hampshire, UK: a service evaluation.

Sarah Williams, Clare Scholfield, Tom Nadarzynski, Ynez Symonds & Sally Kidsley

Introduction:
Home-sampling offers cost-effective and equitable approaches, allowing hard-to-reach populations to remotely access screening for sexually transmitted infections (STIs). We aimed to evaluate a pilot home-sampling service – its utilisation, acceptability and impact on clinic attendance and service delivery, notably its capacity to direct 10% of asymptomatic clinic attenders to the online service.

Methods:
We ran descriptive statistics on six-month data (Sep 2015-Mar 2016) on STI kit requests and completion in Hampshire, and conducted trend analysis to examine the impact on attendances. Overall acceptability was assessed via online feedback survey and in-depth interviews with service users.

Results:
In total, 4,305 kits were requested and 1974 (48%) were returned, with 15% providing insufficient blood samples. After analysis, 73 samples were positive (1 HIV, 1 syphilis, 5 Hepatitis-B, 53 Chlamydia, and 13 Gonorrhoea). There was no significant reduction in asymptomatic attendances since the introduction of the service (p=0.12). While 95% would use the online service again and 93% would recommend it to family and friends, 39% reported difficulties taking blood samples.

Discussion:
Online home-sampling is an acceptable method of screening for STIs. The overall positivity rates are comparable to those reported in the clinic. However, the introduction of the online home-sampling might not reduce clinic attendances, due to the novelty aspects of the service. Further development of online screening needs to increase kit return rate and educate service users on more effective ways of providing sufficient samples for blood analysis.

Contact: Dr Tom Nadarzynski (T.Nadarzynski@soton.ac.uk)