Many jurisdictions face pressures to meet increasing demand for STI clinical services, including prolonged wait-times and turning away drop-in clients. The BC Centre for Disease Control has implemented internet-based STI/HIV testing (GetCheckedOnline.com, GCO) as a virtual extension of clinic services. Here we report on the impact of providing same-day access to GCO through codes for clients seeking testing but unable to be seen (turn-aways).
Starting March 3, 2015, clerical and nursing staff working in an STI clinic in Vancouver provided GCO access codes to turn-away clients presenting in person or by phone seeking testing. On the GCO site, access codes permit clients to create accounts and download requisitions for HIV, syphilis, Chlamydia/gonorrhea +/- Hepatitis C testing. We examined offer, account creation, and testing for turn-away clients and STI clinic clients for the first month of implementation.
Between March 1-31, 2015, codes were provided to 57 of 107 turn-away clients by clerical staff (codes provided by nursing staff not tracked). 34 turn-away clients created accounts (26% female, 74% male; mean age 37 years). By March 31, 21 clients were known to have tested and received all/partial results. Two turn-away clients (10%) tested positive (for Chlamydia and gonorrhea). Over the same period, 536 STI clinic clients were tested (31% female, 69% male; mean age 34 years); 64 clinic clients (12%) tested positive for these infections.
Internet-based STI/HIV testing provides an opportunity to test for clients facing barriers due to clinic capacity. While these findings are preliminary, they suggest referring turn-away clients to GCO at this high-volume clinic increased overall testing capacity and reduced delays in diagnosis. This service has since been implemented at two other STI clinics in Vancouver with differing client populations. Findings from the first five months of implementation across all clinics will be presented.