(P335) Reasons individuals initially engaging with an online sexually-transmitted and blood-borne infection testing service do not test: implications for service design and implementation

Wednesday, July 26, 2023

16:00 – 18:00 CST

Primary Presenter(s)

Aidan Ablona, MPH (he/him/his)

Data Analyst
BC Centre for Disease Control, Canada

Co-author(s)

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
HC

Hsiu-Ju Chang

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

Paul Flowers, PhD

Professor of Psychology and Public Health Psychology Lead
University of Strathclyde, United Kingdom
TS

Travis Salway

Simon Fraser University, Canada
NL

Nathan J. Lachowsky

Associate Professor
Public Health and Social Policy, University of Victoria
Victoria, 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
DH

Darren Ho

Community-Based Research Centre
Vancouver, British Columbia, Canada
TG

Troy Grennan, MD

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

Daniel Grace

University of Toronto
Toronto, Ontario, Canada
CW

Catherine Worthington

Prof
Social DImensions of Health, Public Health and Social Policy, University of Victoria
victoria, British Columbia, Canada
Mark Gilbert, MD

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

Background: Some individuals engaging with online STBBI testing services do not complete testing (i.e., submit specimens) for poorly understood reasons. If individuals needed testing at the time, these may reflect missed opportunities for testing that can be potentially overcome by improvements in service design or implementation. We studied this question among people creating an account on GetCheckedOnline, British Columbia’s online STBBI testing service where users generate lab forms to take to local labs for specimen collection.

Methods: Between Nov 21 - Dec 6, 2022, we invited users of GetCheckedOnline to an online survey who had consented to be contacted for research, were ≥ 16 years, and had created an account in the past 6 months. We descriptively analyzed the characteristics of participants needing but not completing testing (excluding missing responses).

Results: Overall, 3128 account holders were invited and 681 (22%) completed the survey, of whom 84% (572/681) needed testing at account creation (Figure 1). Of the 183 (32% of 572) needing but not completing testing, 62% (98/159) identified as women, 48% (77/159) with a non-heterosexual sexual identity, and 32% (51/159) with an ethnicity other than White. Approximately 37% (58/157) agreed provider-based testing was easily accessible, and 36% (57/158) agreed they had a usual place where they were comfortable getting tested by a provider. Reasons for not proceeding to test through GetCheckedOnline included (n=170): choosing provider-based testing instead (e.g., wanting to speak to a provider; 26%), challenges with the testing process at the laboratory (e.g., not being able to print/display form; 21%), not getting around to taking forms to a lab (19%), no nearby lab (16%), not understanding how the service/process worked (9%), and dissatisfaction with the tests offered (e.g., other tests sought, 8%). Overall, 86% (138/161) agreed they would test through GetCheckedOnline in the future.

Conclusion: While some people needing but not testing through GetCheckedOnline accessed testing through other means, many reported challenges related to the design and implementation of the service. Similar studies can help identify how online testing services may be improved (e.g., for GetCheckedOnline, improving instructions or adding text/email reminders to submit specimens or self-collected sampling kits).