Increased use of internet-based testing for sexually-transmitted and bloodborne infections during the COVID-19 pandemic in British Columbia, Canada

Background: GetCheckedOnline is a publicly-funded internet-based testing service for sexually-transmitted and blood borne infections (STBBI) offered in British Columbia (BC), Canada since 2014. GetCheckedOnline has remained accessible since the beginning of the COVID-19 pandemic response, despite many in-person sexual healthcare services having been reduced or stopped. GetCheckedOnline users complete an online risk assessment to inform STBBI test recommendations, auto-generating a lab requisition which can be used at any participating laboratory location, with results available online or by phone. Our objective was to describe GetCheckedOnline program utilization and selected risk factors before and during the COVID-19 pandemic.

Approach: We used linked GetCheckedOnline program and laboratory testing data for this analysis. We compared the mean of selected monthly program measures during the COVID-19 pandemic (March 2020 – December 2020) to the same time period the previous year, defined as pre-pandemic (March 2019 – December 2019). Descriptive statistics are presented.

Outcomes: The median number of monthly test episodes completed was higher during the pandemic (median=1088; n=9470 total episodes completed), compared to pre-pandemic (median=824, n=8237 total episodes completed), despite a sharp decline and rapid recovery in March-May 2020. During the pandemic, the mean proportion of test episodes completed by those using GetCheckedOnline for the first time was 57%;
an increase from pre-pandemic (51%). We observed an increase in the percent positivity during the pandemic compared to pre-pandemic (6.44% vs. 5.72%), as well as in the mean proportion of those reporting symptoms (20.3% vs 19.4%) or being a contact to someone with an STBBI (11.0% vs 9.3%).

Innovation and Significance: The increase in first time GetCheckedOnline testers, percent positivity, and those reporting symptoms or being a contact to an STBBI during the COVID19 pandemic suggest the program has filled a gap in STBBI testing services, and remains a critical service for accessing sexual healthcare.