title: Fully integrated e-services for prevention, diagnosis, and treatment of sexually transmitted infections: results of a 4-county study in California.
abstract: OBJECTIVE
  We examined the acceptability, feasibility, and cost of a fully integrated online system (eSTI) for sexually transmitted infection (STI) testing, treatment, and linkage to care with 4 Northern California health departments.
  
  
  METHODS
  In April 2012, we implemented the eSTI system, which provided education; testing of self-collected vaginal swabs for chlamydia, gonorrhea, and trichomoniasis; e-prescriptions; e-partner notification; and data integration with clinic electronic health records. We analyzed feasibility, acceptability, and cost measures.
  
  
  RESULTS
  During a 3-month period, 217 women aged 18 to 30 years enrolled; 67% returned the kit. Of these, 92% viewed their results online. STI prevalence was 5.6% (chlamydia and trichomoniasis). All participants with STIs received treatment either the same day at a pharmacy (62%) or within 7 days at a clinic (38%). Among participants completing follow-up surveys, 99% would recommend the online eSTI system to a friend, and 95% preferred it over clinic-based testing within a study.
  
  
  CONCLUSIONS
  The fully integrated eSTI system has the potential to increase diagnosis and treatment of STIs with higher patient satisfaction at a potentially lower cost.
authors.affiliation: Freya Spielberg is with the Department of Prevention and Community Health, George Washington University, Washington, DC. Vivian Levy and Teresa P. Lopez are with the San Mateo County Health System, San Mateo, CA. Shelly Lensing is with University of Arkansas for Medical Sciences, Department of Biostatistics, Little Rock. Ishita Chattopadhyay is with Research Triangle Institute International, Research Triangle Park, NC. Lalitha Venkatasubramanian and Nincoshka Acevedo are with FHI 360, Durham, NC. Peter Wolff is with the National Institute of Allergy and Infectious Diseases, Bethesda, MD. Debra Callabresi is with N-tonic, Los Angeles, CA. Susan Philip is with the San Francisco Department of Public Health, San Francisco, CA. Nancy Padian is with the Berkeley School of Public Health, Berkeley, CA. Diane R. Blake is with the Department of Pediatrics, University of Massachusetts Medical School, Worcester. Charlotte A. Gaydos is with the Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD.
authors.forename: Freya
authors.initials: F
authors.lastname: Spielberg
authors.forename: Vivian
authors.initials: V
authors.lastname: Levy
authors.forename: Shelly
authors.initials: S
authors.lastname: Lensing
authors.forename: Ishita
authors.initials: I
authors.lastname: Chattopadhyay
authors.forename: Lalitha
authors.initials: L
authors.lastname: Venkatasubramanian
authors.forename: Nincoshka
authors.initials: N
authors.lastname: Acevedo
authors.forename: Peter
authors.initials: P
authors.lastname: Wolff
authors.forename: Debra
authors.initials: D
authors.lastname: Callabresi
authors.forename: Susan
authors.initials: S
authors.lastname: Philip
authors.forename: Teresa P
authors.initials: TP
authors.lastname: Lopez
authors.forename: Nancy
authors.initials: N
authors.lastname: Padian
authors.forename: Diane R
authors.initials: DR
authors.lastname: Blake
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D057286:Electronic Health Records; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020407:Internet; D017060:Patient Satisfaction; D062486:Public Health Surveillance; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D014626:Vaginal Smears