Sexual health service access during the COVID-19 pandemic: Increased use of internet-based sexually-transmitted and blood borne infections (STBBI) testing in British Columbia

Background:
GetCheckedOnline is an internet-based testing service for sexually-transmitted and blood borne infections (STBBI) offered in select British Columbia (BC) communities since late 2014. 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. While many in-person sexual healthcare services were reduced or stopped due to COVID-19, GetCheckedOnline remained accessible. We describe GetCheckedOnline program utilization and selected risk factors before and during the COVID-19 pandemic.

Methods:
We used GetCheckedOnline and linked laboratory testing data to generate descriptive statistics. 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).

Results:
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%).

Conclusion:
The increase in first time GetCheckedOnline testers, percent positivity, and those reporting symptoms or being a contact to an STBBI during the COVID-19 pandemic suggest the program has filled a gap in STBBI testing services in BC, and remains a critical service for accessing sexual healthcare.