Check digital trends in STI prevention
Executive Summary
The Internet and the cell phone are helping patients in not only seeking testing for sexually transmitted infections (STIs), but learning their test results and promoting treatment for themselves and their partners.
• STD Triage has partnered with getSTDtested.com, an online STI testing and treatment service, to provide virtual STI testing and telemedicine consultation options. Hula, a free mobile app and online presence, offers a free way to find STD testing centers, obtain results online, and share test status.
• So They Can Know is a website designed to increase rates of STI partner notification. Visitors can look up information and watch videos about how to notify their partners in person, on the phone, via email, or via text message. They also can inform their partners by sending anonymous emails generated by the website.
The Internet and the cell phone are being employed in helping patients in not only seeking testing for sexually transmitted infections (STIs), but also learning their test results and promoting treatment for themselves and their partners.
For those who might be reticent in coming in for STI testing, STD Triage, (www.stdtriage.com) launched in March 2013 by Stockholm, Sweden-based iDoc24, is an anonymous, app-based dermatology service that allows users to submit pictures of possible STI symptoms via Apple iOS and Android smartphones, as well as on the web. Pictures are reviewed by a team of licensed dermatologists who provide an assessment within 24 hours for $39.99 (U.S. dollars) per case.
STD Triage has partnered with Chicago-based getSTDtested.com, an online STI testing and treatment service, to provide virtual STI testing and telemedicine consultation options. When symptoms might be caused by an STI, STD Triage doctors recommend a confirmation through STI testing. The getSTDtested.com web site serves as the testing platform, offering fast, same-day STD testing at 4,000 locations nationwide, and it also offers at-home tests for gonorrhea, chlamydia, and trichomoniasis. If results are positive, patients can receive counseling via phone. If the patient wishes to have an internet physician prescribe treatment, a separate $60 fee is charged.
The traditional route of STI testing with long waits, appointments, and embarrassing exams isn’t for everyone, said Benjamin Brown, director of getSTDtested.com, in an announcement of the joint partnership. GetSTDtested.com and STD Triage are committed to providing private, physician-backed telemedicine alternatives, Brown stated. "This partnership connects customers with online resources at every stage of the process — from pre-testing consultations to treatment — for a convenient, accurate testing experience," he noted.
Hula, a free mobile app and online presence, offers a free way to find STI testing centers, obtain results online, and share verified STI status. To register for a Hula account, patients go to www.hulahq.com, select "Hula for consumers," and fill out information about themselves and where they were tested. After patients sign their name with their mouse or finger, the site uses the entered personal information to automatically generate a medical records request form that complies with the federal Health Insurance Portability and Accountability Act (HIPAA). The site then attaches the patient’s signature and sends the form to the named testing provider.
The provider receives the request and sends the results back to the patient’s secure Hula account. The results are encrypted within the Hula system, so no one can see the results except for the patient and the Hula employee processing the data. Once the results are in the patient’s account, they can be stored and shared however they choose.
Regarding "virtual" STI services, digital or online services can increase access to STI information or diagnosis, says Andrew Kaunitz, MD, professor and associate chair in the Obstetrics and Gynecology Department at the University of Florida College of Medicine — Jacksonville. One concern, however, is that while a face-to-face encounter with a clinician might result in additional important STI evaluation (such as serologic screening for HIV/hepatitis/syphilis, in addition to screening for lower genital tract infections), such broader evaluations would seem less likely to occur with these new digital/online STI services, says Kaunitz.
Innovations aid patients
STIs present barriers to routine clinical care and diagnosis due to associated stigma, costs, and confidentiality issues.1 Even when tested, 30%-74% infected patients never return for routine test results or are lost to follow-up for treatment.2
So They Can Know (www.sotheycanknow.org) is a website designed to increase rates of STI partner notification. It is targeted at person who are age 15-24 and have been diagnosed with an STI. At the site, visitors can look up information and watch videos about how to notify their partners in person, on the phone, via email, or via text message. They also can inform their partners by sending anonymous emails generated by the website. These emails provide relevant health information and links to locate nearby testing services. Since its September 2012 launch, the web site has generated 35,114 unique website visitors, and 113 clinics nationwide are promoting the service to their patients.
A companion web site, www.STCKClinic.org, is designed to help evaluate the uptake of So They Can Know (STCK) among patients of STI clinics and family planning services across the United States. The STCK Clinic website also is designed to elicit feedback from clinicians, nurses, disease intervention specialists, and other public health practitioners.
So They Can Know and STCKClinic are outreach programs developed by New York City-based Sexual Health Innovations, a nonprofit organization dedicated to creating technology to improve sexual health and wellbeing in the United States. It is working with Private Results, developed with the Baltimore City Health Department. The Private Results program is an open-source online and phone-based STI test results delivery system.
The program takes data from laboratories and displays it securely and clearly to patients. It translates confusing results such as "Syphilis RPR Non-Reactive" to "your syphilis test was negative, meaning that you do not have syphilis." The program is designed to help patients understand what their results mean, what next steps they need to take to keep themselves and their partners healthy, and links to more information and tools. On the provider side, the program allows clinicians to track who has and hasn’t seen their results yet, so they know who needs follow up contact, and it allows providers to easily view trends in STI diagnoses over time for better detection and response to emerging outbreaks.
Baltimore is the only health department working with the Private Results program, says Jessica Ladd, MPH, founder and executive director of Sexual Health Innovations. Clinics who are interested in possible participation may e-mail the organization at [email protected] or sign up for updates at www.PrivateResults.org, Ladd says.
- Gaydos CA. STI management and control in North America IUSTI region. Sex Transm Infect 2011; 87 Suppl 2:ii2-6.
- Bachmann LH, Richley CM, Waites K, et al. Patterns of Chlamydia trachomatis testing and follow-up at a university hospital medical center. Sex Transm Dis 1999; 26:496-499. n
