Publication date: Feb 01, 2026
A shift to online postal self-sampling (OPSS) for sexually transmitted infections (STIs) in high-income settings has occurred. We evaluate whether introduction of OPSS in England is associated with changes in testing activity and if this differs by population characteristics. A retrospective study of sexual health (online and clinic-based) service-level data, across three case study areas (CSAs) that implemented OPSS at different times, using different models, and whose populations have different socio-demographic profiles, between 01/01/2015 and 31/12/2022 (from 01/08/2014 in CSA1 to ensure 12 months pre-OPSS). The primary outcome was chlamydia/gonorrhoea and HIV testing activity. We evaluated change over time using selected calendar years, with total activity following introduction of OPSS (2019 and 2022) compared to pre-OPSS periods (CSA1, 2014-2015, CSA2 2017, CSA3 2019), and whether outcome changes differed by socio-demographic characteristics. In all CSAs chlamydia/gonorrhoea and HIV testing activity increased following introduction of OPSS with incidence rate ratios (IRR) for chlamydia/gonorrhoea testing in 2022 compared to pre-OPSS baseline ranging from 2. 1 (95% CI 2. 1-2. 2) in CSA1 to 2. 5 (95% CI 2. 4-2. 5) in CSA3, and for HIV testing from 1. 5 (95% CI 1. 5-1. 5) in CSA1 to 2. 8 (95% CI 2. 8-2. 8) in CSA2. Differences existed across all demographic characteristics in the relative change in testing incidence (all P
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| Concepts | Keywords |
|---|---|
| Healthcare | Digital health |
| Hiv | Online STI testing |
| Online | Sexual health |
| STI service provision | |
| STIs |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | Sexually transmitted infection |
| drug | DRUGBANK | Dimethyl sulfone |
| disease | MESH | COVID-19 |