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Sexual Health Sexual Health Society
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Use of the internet and self-collected samples as a sexually transmissible infection intervention in rural Illinois communities

Wiley D. Jenkins A D , Charlie Rabins B , Mathilda Barnes C , Patricia Agreda C and Charlotte Gaydos C

A Southern Illinois University School of Medicine, Department of Family and Community Medicine, 913 N Rutledge Street, PO Box 19671, Springfield, IL 62791-9671, USA.

B Illinois Department of Public Health, Sexually Transmitted Diseases Section, 525 W Jefferson Street, Springfield, IL 62672, USA.

C Johns Hopkins University, 530 Rangos Building, 855 North Wolfe Street, Baltimore, MD 21205, USA.

D Corresponding author. Email:

Sexual Health 8(1) 79-85
Submitted: 9 February 2010  Accepted: 30 March 2010   Published: 24 January 2011


Background: In the USA, reported cases of chlamydia (Chlamydia trachomatis) continue to rise despite substantial funding for screening. National gonorrhoea (Neisseria gonorrhoeae) rates have remained relatively stable, with clusters associated with metropolitan areas. Rural areas are no exception, as every county in Illinois reported cases of chlamydia in 2007. Morbidity associated with infection remains a public health concern, with costs of $US2.5+ billion annually. Novel screening interventions must be examined for their ability to reach those at risk who are missed by traditional methods. Methods: The website was modified to allow residents from 25 contiguous counties in Central Illinois to request a self-collected sample kit. Returned kits were tested for chlamydia and gonorrhoea. The initial study period was 12 months. Results: During the study period, 343 kits were requested from 20 counties and 39.9% were satisfactorily returned for analysis. Positivity rates for chlamydia and gonorrhoea were 5.8% and 1.2%, respectively, for females and 1.9% and 0% for males. Males comprised 37.7% of all internet samples (compared with 23.4% for traditional screening venues) and 40.4% of all internet samples submitted by whites (compared with only 17.2% of traditional screening). Conclusions: The female positivity rate was comparable to those seen in other screening venues and the method successfully engaged at-risk males. Overall, participation was low and the costs associated with the program outweighed the averted costs associated with the few cases identified. While this methodology resulted in sample requests from a wide area, it must be utilised by more individuals to become cost-effective.

Graphical Abstract Image

Additional keywords: chlamydia, gonorrhoea, testing.


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