A Review of the Scope of Direct-to-Consumer Sexually Transmitted Infection Testing Services Offered on the Internet

• Published in: Sexually transmitted diseases Vol. 50; no. 6; pp. 323 - 328
• Main Authors: Manca, Ellie, Van der Pol, Barbara, Exten, Cara, Pinto, Casey N.
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-06-2023; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Averages; Chlamydia; Chlamydia trachomatis; Collection; Consumers; Emerging markets; Gonorrhea; Gonorrhea - epidemiology; Health care; HIV Infections - epidemiology; Humans; Infections; Internet; Laboratories; Medical personnel; Medical screening; Prescription drugs; Qualitative analysis; Qualitative research; Risk assessment; Search engines; Sexually transmitted diseases; Sexually Transmitted Diseases - diagnosis; Sexually Transmitted Diseases - epidemiology; Sexually Transmitted Diseases - prevention & control; Specimen Handling - methods; STD; Tests; Vendors; Volunteers; Websites
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/OLQ.0000000000001783

The prevalence of sexually transmitted infections (STIs) is at an all-time high. Direct-to-consumer STI testing services may help alleviate this undue health burden. These products are sold online and rarely require interaction with a health care professional (HCP). Vendors offer STI self-collection kits or prescriptions for HCP specimen collection. The objective was to understand the scope of direct-to-consumer STI testing services offered and provide recommendations for consumers and industry.
Seven volunteers searched for "STD tests" on Google from February 1 through March 31, 2021 and shared their top 3 results. The study team extracted data from consumer-facing information on each website. Descriptive statistics and thematic qualitative analyses were performed.
Twenty vendors were identified. Most vendors (95%) used Clinical Laboratory Improvement Amendments (CLIA)-certified or College of American Pathologists (CAP) accredited laboratories. Analyses distinguished between STI self-collection kits (n = 9) using independent laboratories and HCP specimen collection (n = 10), which used commercial laboratories (n = 1 offered both). The STI self-collection kits were cheaper per test and bundle on average (eg, $79.00 vs. $106.50 for chlamydia/gonorrhea), and more closely aligned with clinical recommendations compared with the HCP specimen collection options. Websites often contained inaccurate or misleading information (n = 13), often promoting testing outside of the recommendations.
Direct-to-consumer STI testing services are part of an emerging market lacking regulation. Consumers should select vendors offering prescriptions for HCP specimen collection at CAP accredited and CLIA-certified laboratories. Vendors should provide a screening tool to assess individual patient risk prior to test purchase.