(P497) Moving towards online-based STI testing and treatment services for young people: who will use it and what do they want?

Background:

In the context of rising STI notifications and capacity constraints on sexual health clinics, the emergence of online STI testing services and self-testing options can help expand access. Our study aimed to understand young Australian’s preferences for online STI testing and treatment services.

Methods:

We recruited Australians aged 16-29 to an online survey using social media and other networks. We assessed their preferences for being: i) triaged for testing (online questionnaire, telehealth consultation, a hybrid of both); ii) tested for STIs (attend lab for specimen collection, self-sampling using home-kits which are mailed to lab); iii) treated (tablets provided by mail; at pharmacy via e-script, at attended clinic). Multivariable multinomial regression (relative risk ratio [RRR]) assessed sociodemographic factors associated with service preferences.

Results:

Of 905 individuals, 41% were same sex-attracted, 13% trans/non-binary, 24% culturally/linguistically diverse (CALD), and 21% resided rurally.

For triage, 42% preferred an online questionnaire, 9% telehealth consultation, and 48% a hybrid approach. Rural versus urban youth preferred online questionnaire compared with telehealth (RRR=1.92; 95%CI 1.04 to 3.55), whereas CALD were less likely to select online (RRR=0.43; 95%CI 0.24 to 0.79).

For testing, most preferred homekits for urine (65%) and for swabs (71%), but not bloods (29%). Preference for homekits over pathology labs was positively associated with rural location (RRR=2.45; 95%CI 1.13 to 5.29) and negatively with CALD identity (RRR=0.54; 95%CI 0.30 to -2.06). Increased privacy was the most common reason for selecting homekits, with 86% willing to provide some co-payment (median $20, IQR $15-35).

For treatment, most preferred to receive an e-script (63%), with only 10% preferring tablets by mail. Compared to clinic-provided treatment, mailed tablets appealed to rural youth (RRR:2.31; 95%CI 1.16 to 4.63) and older youth aged (25-29) (RRR=6.31; 95%CI 2.39 to 16.69), but not trans/non-binary individuals (RRR=0.17; 95%CI 0.05 to 0.61), while CALD individuals (RRR=0.52; 95%CI 0.35 to 0.78) were less likely to choose e-scripts.

Conclusion:

Our results show significant interest in self-sampling and automated prescriptions. Preferences for online and non-clinic facing options likely reflect different barriers to service use encountered by different populations, and may differentially attract rural youth and CALD individuals.