A study of internet STI testing sites from the United States has found that the quality is variable and often poor.

The study aimed to investigate the reliability of such services by ordering and evaluating their test kits. Using search engines such as Google, Yahoo and Ask, the authors identified internet sites offering STI tests and tried to obtain information about costs, services, accuracy, types of tests, privacy policies and return of test results.

These internet businesses were also contacted by phone, email and mail for an in-depth interview about their programme, especially the management of positive test results. Another part of the study used test kits from six commercial sites and one public health site and evaluated their performance on chlamydia- and gonorrhoea-inoculated mock samples.

The study identified 27 sites

(13 international) offering STI kits and services. Available tests included gonorrhoea, syphilis, chlamydia, HIV, herpes, hepatitis, trichomonas, mycoplasma and gardnerella.

Only four sites responded and just two completed the survey. Test results were obtained from five out of seven kits that were ordered. Two websites did not provide results on mock urine specimens; two DIY kits yielded false-negative results. Two urine specimens sent by post yielded correct positive results; the public health site kit also yielded correct positive results.

The authors state their concern that the quality of STI testing services was often poor and called for national regulatory control of quality to protect customers from receiving inaccurate results. However, they do not dismiss entirely the advantage of properly regulated internet-based STI testing services in a broader strategy to encourage more testing for thoseat risk.

With social marketing campaigns making sex ‘worth talking about', it is of course desirable that the public are using the internet not just to source information regarding STIs but also that they are choosing to test for STIs, especially those who are too embarrassed or unwilling to attend their GP or sexual health clinic.  Internet sites that offer STI testing services and advice may be available but they are not free and are not regulated.

In UK practice, it is entirely possible for patients to use internet-based services for DIY testing at home.

We should advise caution if patients choose to use these services and also if they have received test results that are negative.

Dr Richard Ma