Utilizing the Internet to Test for Sexually Transmitted Infections: Results of a Survey and Accuracy Testing

Acknowledging that searching the World Wide Web for information about sexually transmitted infections is common, the authors carried out the current study to determine which Internet sites offer STI testing and to obtain information about the services and their validity.

The researchers used Internet search engines to collect information from the sites about STI testing services, the types of tests offered, and their costs. Business functions regarding consent and return of results also were investigated. Attempts to contact the services were made by telephone, mail, e-mail, and "contact us" links. Team members ordered test kits from six commercial sites and one public health site. The test kits' accuracy for detecting chlamydia and gonorrhea was evaluated.

Twenty-seven US and international Internet sites offering STI self-collection kits and services were identified. Tests were offered for gonorrhea, syphilis, chlamydia, HIV, herpes, hepatitis, trichomonas, mycoplasma, and gardnerella.

"All attempts to administer the survey yielded unsatisfactory results," the authors wrote. "After sending the survey by mail/e-mail to all the sites, four responded, two with the survey. Six Web sites appeared invalid based on non-deliverable e-mails and returned letters. The remainder did not respond."

Seven test kits were ordered; results were obtained from five kits. Two Web sites that were sent mocked urine specimens never provided results. The two "do-it-yourself" test kits yielded false-negative results. Correct positive results were obtained from two mailed-in urine samples. Correct positive results were obtained from the public health site's kit.

"The Internet STI testing sites were difficult to contact and demonstrated unwillingness to answer consumer-specific questions," the authors concluded. "Test accuracy varied, with home tests having poor accuracy and mail-in specimens demonstrating high accuracy."

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