Moving towards online-based STI testing and treatment services for young people: Who will use it and what do they want?

Abstract

ABSTRACT Introduction The market for online STI services is rapidly expanding. Online health services often have unequal uptake among different demographics of the population. There is a need to understand how different online delivery options for STI testing may appeal to different groups of young people, particularly young people who have higher rates of STI diagnoses or access barriers. Materials and methods An online survey of young Australians aged 16-29 was conducted to understand service preferences regarding: consultation (telehealth, fully automated questionnaire); testing (electronic pathology form, at-home self-sampling); treatment (e-prescriptions, mailed oral tablets); and partner notification (web tools). Multivariable multinomial logistic regression examined associations between user characteristics and service preferences and adjusted relative risk ratios (aRRR) and 95% confidence intervals are presented. Results Among 905 respondents, rural youth were more likely to prefer fully automated questionnaires (aRRR = 1.9; 95% CI 1.0 to 3.5) over telehealth consultations, whereas culturally and linguistically diverse youth (CALD) were less likely (aRRR = 0.4; 95% CI 0.2 to 0.7). Rural youth preferred at-home self-sampling kits (aRRR = 1.9; 95% CI 1.3, 2.7) over electronic forms for on-site collection at pathology centres, with the opposite for CALD youth (aRRR = 0.7; 95% CI 0.5,1.0). Receiving oral antibiotics by mail was preferred by rural youth (aRRR:2.3 95% CI 1.1, 4.6) over for in-clinic treatment, but not for CALD youth (aRRR = 0.5; 95% CI 0.4, 0.8). Discussion Our findings suggest that rural youth tend to prefer self-navigated and automated options whereas CALD prefer options with greater provider engagement. Online STI service providers should consider how different service options may affect equitable uptake across the population, and implications for addressing disparities in testing and treatment.