title: Internet-based screening for sexually transmitted infections to reach nonclinic populations in the community: risk factors for infection in men.
abstract: BACKGROUND
  Internet-based screening for sexually transmitted infections (STIs) has been acceptable to women, and can reach high-risk populations. No prior published data describe internet-based screening for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis in men. We studied whether internet-based screening was acceptable and reached a high-risk population, and what risk factors were associated with STI positivity.
  
  
  METHODS
  The website, www.iwantthekit.org, encouraged men ≥14 years of age to request a home self-sampling kit and a questionnaire on risk factors and acceptability of internet-based screening. Penile swabs and urine samples were tested for C. trachomatis, N. gonorrhoeae, and T. vaginalis using a nucleic acid amplification test. Risk factors and acceptability were examined using chi squared tests and logistic regression.
  
  
  RESULTS
  Of 501 samples received for testing, 106 (21%) were positive for at least one STI, 64 (13%) for chlamydia, 4 (1%) for gonorrhea, and 49 (10%) for trichomonas. In multivariable analyses, age, race, household income, and frequency of condom use were independently associated with infection with at least one STI. Of the total respondents, 34% had a prior STI; 29% reported having a partner with an STI, but only 13% reported always using a condom. Among the men who participated in this study, 77% preferred a self-administered specimen versus attending a clinic, 89% reported that swab use was easy, and 89% reported that they would use internet-based screening again.
  
  
  CONCLUSIONS
  Men who accessed internet-based screening had known risk factors for STIs and had a high prevalence of infection. Internet-based screening was acceptable and could reach these high-risk men who might not otherwise be reached through traditional means.
authors.affiliation: Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA.
authors.forename: Shua J
authors.initials: SJ
authors.lastname: Chai
authors.forename: Bulbulgul
authors.initials: B
authors.lastname: Aumakhan
authors.forename: Mathilda
authors.initials: M
authors.lastname: Barnes
authors.forename: Mary
authors.initials: M
authors.lastname: Jett-Goheen
authors.forename: Nicole
authors.initials: N
authors.lastname: Quinn
authors.forename: Patricia
authors.initials: P
authors.lastname: Agreda
authors.forename: Pamela
authors.initials: P
authors.lastname: Whittle
authors.forename: Terry
authors.initials: T
authors.lastname: Hogan
authors.forename: Wiley D
authors.initials: WD
authors.lastname: Jenkins
authors.forename: Cornelis A
authors.initials: CA
authors.lastname: Rietmeijer
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D006069:Gonorrhea / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D020407:Internet; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D011933:Reagent Kits, Diagnostic; D012111:Residence Characteristics; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D014245:Trichomonas Infections / Q000175:diagnosis* / Q000453:epidemiology; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D011933:Reagent Kits, Diagnostic