Online testing: a new way to look after your sexual health

Our first digitally-led service in partnership with SH:24 launches in Cornwall in December. In anticipation of this we hear from Alicia Thornton, Public Health Registrar, about how online testing works and why it holds unique benefits in the context of a diverse population with varying accessibility requirements.

Getting tested for sexually transmitted infections (STIs) is a great part of keeping yourself healthy. In England in 2018 there were 447,694 diagnoses of sexually transmitted infections (STIs) with the most common STI being chlamydia, followed by warts, gonorrhea and herpes. As some STIs do not have symptoms in the early stages, it is possible to have an infection without knowing. 

Having an STI test means that you can get treatment if you need it. Treatment will prevent you developing any complications and also stop you passing the infection to your sexual partners.

Getting to a clinic to have an STI test isn’t always easy or convenient for everyone, so are there any other options? You can now have the option of ordering an STI test online and in some parts of the country this is free through the SH:24 service.

How does the online service work?

You can order a test kit from any computer or mobile device which is connected to the internet by visiting the SH:24 site. SH:24 provides tests for chlamydia, gonorrhea, syphilis and HIV. You will be asked to fill in answers to some questions about yourself, such as you date of birth, gender and whether you have sex with men or women. You will also be asked about any symptoms of STIs that you might be experiencing and which STIs you would like to have a test for.

SH:24’s team of doctors and nurses review all orders for kits to make sure that online testing is the best option. 

In some cases, a member of the clinical team contacts the person who has requested the test to talk in more detail.

Test kits are sent out the same day if the order is made before 3pm and are sent by first class Royal Mail.  Confidentiality is key to the service so all kits are sent in plain envelopes without any mention of sexual health or STIs. The envelope will fit through a letterbox.

For people who have requested an HIV and/or syphilis test, a blood sample is required.  For women who have requested a chlamydia and/or gonorrhea test, a vaginal swab is needed. For men, a urine sample can be used to test for chlamydia or gonorrhea and for men who have sex with men, anal and oral swabs are needed in addition to the urine sample.  All these samples are self-taken and the kits come with step-by-step instructions on how to take them.  There is also a video showing how to take a blood sample. You only need about 15 drops of blood to do the tests.

Kits are returned to the lab using a Freepost envelope, which does not include any personal details inside or on it.  Test results are sent out by text message within 7 days (and often sooner).  If you have an infection we will contact you to advise you on how to get treatment.

What are the benefits of online testing?

First and foremost, online testing provides users with an opportunity to take charge of their own sexual health.  A test kit can be ordered 24 hours a day and you can take the samples at a time and place that is convenient to you. 

There are lots of reasons that people may not find it easy to go to a sexual health service – the clinics might be too far away or not easy to get to on public transport, clinic opening times might be during work, school or college hours, or people may not feel comfortable talking about their sexual health face-to face in a clinic.  Online testing overcomes these barriers for users while also making sure that people get treatment and support when they need it.  SH:24 aims to provide a personalised service and offer one-to-one support and advice over the phone or via text, in addition to the testing.

By providing the option of online testing it is possible to take some pressure away from busy clinics and free up some of their time to deal with more complicated cases.  But the option of testing within  a clinic is always there for those people who want it.

How successful is the service?

SH:24 has been operating since 2014. Since then over 245,000 people have chosen to test with the service and the SH:24 team is currently sending out over 4,000 kits per week. On average, users get their test results within 3 days. From the outset, users were involved in designing the service.

In addition to this, there were over 10,000 people every month trying to access the SH:24 service in uncommissioned areas. That’s why the team created Fettle, a new online health service, to provide affordable and trusted services to people who can choose not to use the NHS. All Fettle profits are channelled back into SH:24.

Online testing is a really important way of widening access to sexual health services as it can break down barriers to STI testing and make sure that everyone has the opportunity to test as and when they need.

From 1 December 2019 Brook & SH:24 will be delivering a new innovative all-age sexual health service in Cornwall.

Research shows that online services improve access for all populations but in rural settings where travel to clinics can be difficult, 24/7 online services is particularly important.  We look forward to working with Brook on this innovative service.

SH:24 Clinical Director, Paula Baraitser

Building on more than 25 years’ experience delivering young people’s services across the county, and over 55 years nationwide, Brook is well placed to understand challenges and meet the needs of Cornwall’s unique population.