Internet-based screening for sexually transmitted infections to reach nonclinic populations in the community: risk factors for infection in men

Sex Transm Dis. 2010 Dec;37(12):756-63. doi: 10.1097/OLQ.0b013e3181e3d771.


Background: Internet-based screening for sexually transmitted infections (STIs) has been acceptable to women, and can reach high-risk populations. No prior published data describe internet-based screening for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis in men. We studied whether internet-based screening was acceptable and reached a high-risk population, and what risk factors were associated with STI positivity.

Methods: The website,, encouraged men ≥14 years of age to request a home self-sampling kit and a questionnaire on risk factors and acceptability of internet-based screening. Penile swabs and urine samples were tested for C. trachomatis, N. gonorrhoeae, and T. vaginalis using a nucleic acid amplification test. Risk factors and acceptability were examined using chi squared tests and logistic regression.

Results: Of 501 samples received for testing, 106 (21%) were positive for at least one STI, 64 (13%) for chlamydia, 4 (1%) for gonorrhea, and 49 (10%) for trichomonas. In multivariable analyses, age, race, household income, and frequency of condom use were independently associated with infection with at least one STI. Of the total respondents, 34% had a prior STI; 29% reported having a partner with an STI, but only 13% reported always using a condom. Among the men who participated in this study, 77% preferred a self-administered specimen versus attending a clinic, 89% reported that swab use was easy, and 89% reported that they would use internet-based screening again.

Conclusions: Men who accessed internet-based screening had known risk factors for STIs and had a high prevalence of infection. Internet-based screening was acceptable and could reach these high-risk men who might not otherwise be reached through traditional means.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / epidemiology
  • Chlamydia trachomatis / isolation & purification
  • Gonorrhea / diagnosis*
  • Gonorrhea / epidemiology
  • Humans
  • Internet*
  • Logistic Models
  • Male
  • Mass Screening / methods*
  • Neisseria gonorrhoeae / isolation & purification
  • Patient Acceptance of Health Care*
  • Prevalence
  • Reagent Kits, Diagnostic
  • Residence Characteristics
  • Risk Factors
  • Sexually Transmitted Diseases / diagnosis*
  • Surveys and Questionnaires
  • Trichomonas Infections / diagnosis*
  • Trichomonas Infections / epidemiology
  • Trichomonas vaginalis / isolation & purification
  • Young Adult


  • Reagent Kits, Diagnostic