Use of GetCheckedOnline, a Comprehensive Web-based Testing Service for Sexually Transmitted and Blood-Borne Infections.
The British Columbia Centre for Disease Control implemented a comprehensive Web-based testing service GetCheckedOnline (GCO) in September 2014 in Vancouver, Canada. GCO's objectives are to increase testing for sexually transmitted and blood-borne infections (STBBIs), reach high-prevalence populations facing testing barriers, and increase clinical STI service capacity. GCO was promoted through email invitations to provincial STI clinic clients, access codes to clients unable to access immediate clinic-based testing (deferred testers), and a campaign to gay, bisexual, and other men who have sex with men (MSM).



The objective of the study was to report on characteristics of GCO users, use and test outcomes (overall and by promotional strategy) during this pilot phase.



We used GCO program data, website metrics, and provincial STI clinic records to describe temporal trends, progression through the service pathway, and demographic, risk, and testing outcomes for individuals creating GCO accounts during the first 15 months of implementation.



Of 868 clients creating accounts, 318 (36.6%) submitted specimens, of whom 96 (30.2%) tested more than once and 10 (3.1%) had a positive STI diagnosis. The proportion of clients submitting specimens increased steadily over the course of the pilot phase following introduction of deferred tester codes. Clients were diverse with respect to age, gender, and ethnicity, although youth and individuals of nonwhite ethnicity were underrepresented. Of the 506 clients completing risk assessments, 215 (42.5%) were MSM, 89 (17.6%) were symptomatic, 47 (9.3%) were STI contacts, 232 (45.8%) reported condomless sex, 146 (28.9%) reported ≥4 partners in the past 3 months, and 76 (15.0%) reported a recent STI. A total of 63 (12.5%) GCO clients were testing for the first time. For 868 accounts created, 337 (38.8%) were by clinic invitations (0 diagnoses), 298 (34.3%) were by deferred testers (6 diagnoses), 194 (22.4%) were by promotional campaign (3 diagnoses), and 39 (4.5%) were by other means (1 diagnosis).



Our evaluation suggests that GCO is an acceptable and feasible approach to engage individuals in testing. Use by first-time testers, repeated use, and STI diagnosis of individuals unable to access immediate clinic-based testing suggest GCO may facilitate uptake of STBBI testing and earlier diagnosis. Use by MSM and individuals reporting sexual risk suggests GCO may reach populations with a higher risk of STI. Motivation to test (eg, unable to access clinical services immediately) appears a key factor underlying GCO use. These findings identify areas for refinement of the testing model, further promotion, and future research (including understanding reasons for drop-off through the service pathway and more comprehensive evaluation of effectiveness). Increased uptake and diagnosis corresponding with expansion of the service within British Columbia will permit future evaluation of this service across varying populations and settings.
BC Centre for Disease Control, Vancouver, BC, Canada.|School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Mark
0000-0001-5978-6843
M
Gilbert
BC Centre for Disease Control, Vancouver, BC, Canada.
Travis
0000-0002-5699-5444
T
Salway
BC Centre for Disease Control, Vancouver, BC, Canada.
Devon
0000-0003-4955-1017
D
Haag
Melbourne Sexual Health Centre, Melbourne, Australia.|Central Clinical School, Monash University, Melbourne, Australia.
Christopher K
0000-0001-9081-1664
CK
Fairley
BC Centre for Disease Control, Vancouver, BC, Canada.|School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Jason
0000-0002-7681-7573
J
Wong
BC Centre for Disease Control, Vancouver, BC, Canada.|Division of Infectious Diseases, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Troy
0000-0002-8039-6513
T
Grennan
Ottawa Public Health, Ottawa, ON, Canada.
Zhaida
0000-0001-8495-2399
Z
Uddin
Fraser Health, Vancouver, BC, Canada.
Christopher S
0000-0001-6775-2432
CS
Buchner
Health Canada, Ottawa, ON, Canada.
Tom
0000-0002-4678-1055
T
Wong
BC Centre for Disease Control, Vancouver, BC, Canada.|Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Mel
0000-0002-3477-8748
M
Krajden
BC Centre for Disease Control, Vancouver, BC, Canada.|School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Mark
0000-0003-4450-5679
M
Tyndall
School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.|British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
Jean
0000-0002-4616-3556
J
Shoveller
BC Centre for Disease Control, Vancouver, BC, Canada.|School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Gina
0000-0001-5783-4493
G
Ogilvie
D000293:Adolescent; D000328:Adult; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D010865:Pilot Projects; D015995:Prevalence; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000175:diagnosis*; D055815:Young Adult
Internet; diagnostic tests; health care delivery; health services research; intervention study; sexually transmitted diseases