Abstract

Objective: It may be difficult for young people to know if they need testing for sexually transmitted infections and some primary care physicians may be unsure about what tests to order for patients with different risk profiles.

Our aim was to help overcome these barriers by implementing an automated, internet based service that allowed internet users to receive specific recommendations for STI screening based on their online responses to a series of questions relating to their recent sexual practices ('Check Your Risk' (CYR), available at: www.mshc.org.au). This study evaluated this service and compared the risk profile of individuals using CYR with that of patients attending a sexual health centre in the same city over the same time period.

Methods: An automated and individualised web based algorithm was developed using current recommendations for STI testing. The characteristics of individuals visiting CYR were compared to those attending the Melbourne Sexual Health Centre (MSHC) for the first time over the same 6 month period, from January to June 2006.

Results: There were 2492 (59% men, 41% women) who visited the CYR online service and 2735 (59% men, 41% women) who attended the MSHC over the period. 513 (22%) of the men visiting CYR and 467 (18%) of the men visiting MSHC reported sex with other men, with a median of 6 (SD 26.4) and 6 (SD 29.4) partners in the previous 12 months respectively (p = 0.9). 43 (1.8%) of the women visiting CYR and 54 (2.1%) of the women visiting MSHC reported sex with other women, with a median of 1 (SD 9.3) and 1 (SD 2.1) partners in the previous 12 months respectively (p = 0.5).

Among men reporting sex with women only, the median number of female sex partners in the preceding 12 months was 2 (SD 10.6) and 3 (SD 5.8) for those visiting CYR and MSHC respectively (p = 0.8). For women reporting sex with men only, the median number of male partners was 2 (SD 11.1) and 2 (SD 4) for those visiting CYR and MSHC respectively (p = 0.03).

Participants responded favourably to the CYR online service, with 70% rating it as 'useful'; or 'very useful'.

Conclusions: This internet based sexual risk assessment tool was accessed frequently by individuals with a high risk profile that was similar to those who attended the sexual health service in the same city. The CYR service cost A$4000 to set up. CYR effectively increased the outreach of the centre's services substantially, via the internet and was given a positive rating by the majority of its users.