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Online-Mediated Syphilis Testing: Feasibility, Efficacy, and Usage

Koekenbier, Rik H. MSc*; Davidovich, Udi PhD*; van Leent, Edwin J. M. MD, PhD; Thiesbrummel, Harold F. J. MD; Fennema, Han S. A. MD, PhD

Sexually Transmitted Diseases: August 2008 - Volume 35 - Issue 8 - p 764-769
doi: 10.1097/OLQ.0b013e31816fcb0a

Objectives: To determine the feasibility and efficacy of an online-mediated syphilis screening among men who have sex with men.

Methods: We developed a Web site that offered information about syphilis and motivated users to download a referral letter with which they could test for syphilis in a nonclinical setting. A week after the blood test, participants could retrieve their results online. To assess the feasibility and efficacy of the Web site we followed the users through the online procedure and compared the percentage of syphilis infected men detected online with those diagnosed at the local sexually transmitted infection (STI) clinic, during the same time frame. The trial was divided into an initial period of online advertising (4 months) and no advertising (11 months) to examine how advertisements affect usage.

Results: During 15 months, 898 visitors downloaded a referral letter. Of these, 93 (10%) men tested and 96% (90 of 93) obtained their test results online. Through the Web site we found a significantly higher percentage of men who needed treatment for syphilis compared with the STI clinic (50% online vs. 24% STI clinic, P <0.01). Of the Online users who tested positive 33% (3 of 10) had never visited the STI clinic before. In the bannered period there was a monthly average of 15 testers compared with 3 per month in the nonbannered period.

Conclusion: Online-mediated testing for syphilis is feasible and was more successful in detecting men who have sex with men with an early or late syphilis infection than standard procedures. However, longer promotion periods are needed to generate more usage of the online service.

A study of a Web site, initiated by the Amsterdam Health Service, shows that online-mediated testing for syphilis is feasible and was more efficient in detecting men who have sex with men with an early or late syphilis infection than standard screening procedures.

From the *Cluster of Infectious Diseases, Department of Research, Online Research and Prevention Unit, Health Service of Amsterdam; †Department of Dermatology, Academic Medical Center, University of Amsterdam; and ‡Cluster of Infectious Diseases, Health Service of Amsterdam, Amsterdam, The Netherlands

The authors thank Dr. Maiza Campos Ponce for her professional support and mentorship. The authors are indebted to Marion Kolader, MD, and Ronald Geskus, PHD, for their support with the statistical analyses.

Correspondence: Rik Koekenbier, MSc, GGD Amsterdam, Department of Research, Cluster of Infectious Diseases, Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands. E-mail:

Received for publication December 21, 2007, and accepted February 20, 2008.

© Copyright 2008 American Sexually Transmitted Diseases Association