Reach and use of an internet-based sexually-transmitted and blood-borne infection testing survey during scale-up to urban, suburban and rural communities in British Columbia, Canada

Background: Implementation outcomes within populations are key to assessing the impact of online testing services but are not commonly measured.  GetCheckedOnline, British Columbia’s online sexually-transmitted and blood-borne infection (STBBI) testing service, is being scaled up in the province with two waves of expansion from Vancouver to seven urban, suburban and rural communities. We assessed post-expansion reach (awareness), use, and intention to use in these communities.  

Methods: Between July-Sept 2022, we conducted a cross-sectional survey in each community, recruiting in-person and online with oversampling among populations affected by STBBI. Eligible participants were ³16 years old, sexually active, and BC residents. Questions evaluated awareness, use, and intention to use GetCheckedOnline; these outcomes and key sample characteristics are described. 

Results: 1657 eligible individuals were recruited, of whom 67.0% (1099/1641) identified as White, 10.2% (151/1477) as trans and 53.0% (793/1496) as non-heterosexual. Mean age was 33 years (SD 11.8); 39.1% (566/1447) had used illegal/non-prescribed drugs (past year), and 21.5% (315/1466) had ever been homeless. A fifth (20.7%, 319/1543) had never tested for STBBIs, and 66.8% (990/1483) reported experiencing at least one barrier to accessing providers for testing in the past year (e.g., long wait times). Overall, 35.8% (584/1633) were aware of GetCheckedOnlineof whom 56.3% had used the service (324/576). These outcomes varied by wave of expansion: in Wave 1 communities (2016), awareness was 39.6%, and use among aware was 60.1% versus 18.1% and 38.3% in Wave 2 communities (2019-2020), respectively. For 91.1% of participants (1334/1465), it was very easy/easy to go online when needed, and 63.1% (1020/1616) were very likely/likely to use GetCheckedOnline in the future.  

Conclusion: Our study suggests GetCheckedOnline is improving access to STBBI testing in these communities, with half of the people aware of the service using it in a sample where barriers to accessing provider-based testing were common. However, only a third of participants were aware of the service, and further promotion of GetCheckedOnline to increase reach may be beneficial.