(P339) Assessing potential missed opportunities for recommended clinical care among users of GetCheckedOnline, British Columbia’s online testing service for sexually-transmitted and blood-borne infections

Wednesday, July 26, 2023

16:00 – 18:00 CST

Primary Presenter(s)

Mark Gilbert, MD

Public Health Physician
BC Centre for Disease Control / University of British Columbia
Vancouver, United States

Co-author(s)

Aidan Ablona, MPH (he/him/his)

Data Analyst
BC Centre for Disease Control, Canada
HC

Hsiu-Ju Chang

BC Centre for Disease Control
Vancouver, British Columbia, Canada
Ihoghosa O. Iyamu, MD, MDICHA, PhD(c)

PhD Candidate
School of Population and Public Health, University of British Columbia/BC Centre for Disease Control, Vancouver, Canada
Langley, British Columbia, Canada
DH

Devon Haag

BC Centre for Disease Control
Vancouver, British Columbia, Canada
HP

Heather Pedersen

BC Centre for Disease Control
Vancouver, British Columbia, Canada
GO

Gina Ogilvie

BC Centre for Disease Control, United States
TG

Troy Grennan, MD

Physician Lead, HIV//STI Program
BC Centre for Disease Control
Vancouver, British Columbia, Canada

Background: Like many internet-based STI testing services, GetCheckedOnline recommends users reporting symptoms or a partner with an STI (“symptoms/partner”) speak to a health care provider (HCP) instead, as immediate treatment or other tests may be indicated. As all users with positive results speak with a provider, we focused on users testing with symptoms/partner having negative results and assessed engagement with HCPs at the time of testing.

Methods: This analysis is part of a larger online survey which invited GetCheckedOnline users who had created an account or tested between April 7-October 7, 2022, and consented to research ($20 honorarium provided). Survey domains included testing when symptoms/partner, test results, and engagement with HCP. We described these outcomes and, among those with negative results, assessed the association between speaking with a HCP and variables related to healthcare access using bivariate chi-squared tests (significance set at p< 0.05).

Results: Of 4926 GetCheckedOnline clients invited, 1524 (31%) participated; 1224 had tested through GetCheckedOnline (25% once, 20% two times, 26% 3-4 times, 29% more than five times). Half (49%, 592/1224) reported testing through GetCheckedOnline with symptoms/partner of whom 74% (433) had a negative result or were not sure of their result. Just under half (45%, 194/433) of those with a negative/not sure result spoke to a HCP at the time. Comparing participants who spoke (194) and didn’t speak (239), not speaking to a HCP was associated with perceiving GetCheckedOnline to be more private than testing through a HCP (79% didn’t speak vs 69% spoke, p=0.032), being uncomfortable discussing sexual history with HCP (27% vs 16%, p=0.013), and not having a usual place where comfortable to get tested by a HCP (62% vs 47%, p=0.003).

Conclusion: In this exploratory study, we identified potential missed opportunities for recommended clinical care in 20% (239/1224) of GetCheckedOnline testers, which may in part be related to barriers to accessing HCPs. These findings highlight ongoing challenges in accessing HCPs among online testers (often their motivation for use of these services). Further understanding the contexts of these potential missed opportunities for recommended clinical care may help identify whether further service adaptations are needed.