Awareness of internet-based testing for sexually-transmitted and blood-borne infections among sexual minority men in British Columbia, Canada

BackgroundGetCheckedOnline is an internet-based testing program for HIV, Hepatitis C, and other sexually-transmitted infections (STIs) in British Columbia (BC), Canada. The program launched in 2014 in Vancouver, BC’s largest urban centre, and expanded to six smaller urban and suburban BC communities in 2016. We sought to measure GetCheckedOnline awareness among gay, bisexual, and other men who have sex with men (gbMSM), and to identify characteristics that may contribute to program awareness.MethodsSex Now was a cross-sectional online health survey of Canadian gbMSM aged ≥15 years recruited from 10/2019–02/2020. BC residents were asked if they knew about GetCheckedOnline and additional questions related to implementation outcomes. We built a multivariable logistic regression model including all variables significant in univariate analysis to quantify associations with awareness, and report adjusted odds ratios and 95% confidence intervals (AOR [95%CI]).ResultsAmong participants living in regions where GetCheckedOnline is available (n=1132, median age: 36 years), 38.1% were aware of GetCheckedOnline. Greater GetCheckedOnline awareness was associated with living outside of Vancouver (AOR=2.15 [1.50–3.10]), identifying as queer (AOR=1.58 [1.13–2.21]), having post-graduate education (AOR=1.84 [1.17–2.91]), being out to healthcare providers (AOR=1.97 [1.22–3.24]), using ≥3 geolocation-based sex-seeking apps (AOR=2.15 [1.40–3.33]), and past-year involvement in LGBTQ2S+-specific activities (AOR=1.56 [1.10–2.23]). Awareness decreased with increasing years of age (AOR=0.98 [0.97–1.00]). Compared with participants who usually tested for STIs at a sexual health clinic, awareness was lower among participants who usually tested for STIs through their family doctor (AOR=0.50 [0.33–0.73]) or at walk-in medical clinics (AOR=0.54 [0.30–0.96]), and among those who had never tested for STIs previously (AOR=0.17 [0.06–0.39]).ConclusionAlmost 40% of gbMSM in our sample were aware of GetCheckedOnline. Increasing promotion to gbMSM who are not out to their healthcare provider, who have never tested previously for STIs, or who are less connected to LGBTQ2S+ communities may improve program reach.

P331 Acceptability of alternative sexual health service delivery methods during the COVID-19 pandemic in British Columbia (BC), Canada

BackgroundIn response to the COVID-19 pandemic, sexual health services have started to implement alternative service delivery methods that reduce in-person contact (e.g., telemedicine, virtual health). We sought to understand acceptability of alternative service delivery methods among sexual health service clients in BC, Canada.MethodsWe used data from an online anonymous survey administered from 21/07/2020–04/08/2020 to clients (aged ≥16 years) who had used the BC Centre for Disease Control’s sexually-transmitted infection (STI) clinic and/or the GetCheckedOnline testing service in the year prior to COVID-19 public health responses (03/2020). We described participants’ likelihood of using potential alternative sexual health service delivery methods, and conducted bivariate analysis to examine its association with experiencing any sexual health service access barriers during the pandemic.ResultsOf the 1198 survey participants (aged 17–76 years), 48% identified as men, 47% as women, and 5% as another gender;71% identified as White, 24% as racialized minorities, and 4% as Indigenous. Overall, support for using alternative STI testing models was high, with 88% likely to use at-home self-collection kits and 79% likely to use an express testing model (i.e., phone/video triage prior to specimen collection at a clinic). More participants were likely to discuss sexual health with a healthcare provider over the phone (64%), compared with video visits (53%) and text (49%). Text messaging to receive STI test results and reminders were of high interest (71% and 63% likely to use, respectively). Likelihood of using alternative service delivery methods did not differ by participants’ experience of access barriers, where 66% of total participants reported having avoided/delayed seeking services during 03/2020–07/2020.ConclusionLikelihood of using potential alternative sexual health service delivery methods was high overall, including among participants who did not avoid/delay seeking services. Sustaining and expanding such services would facilitate access during and beyond the COVID-19 pandemic.

O04.6 Increased use of internet-based testing for sexually-transmitted and bloodborne infections during the COVID-19 pandemic in British Columbia, Canada

BackgroundGetCheckedOnline 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.ApproachWe 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.OutcomesThe 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 SignificanceThe 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, and remains a critical service for accessing sexual healthcare.

O04.5 Impacts of the COVID-19 pandemic on accessing needed sexual health services during March–July 2020 in British Columbia (BC), Canada

BackgroundThe COVID-19-pandemic impacts on sexual health services access have not been fully examined. We sought to describe characteristics associated with unmet sexual health needs and access barriers during the initial pandemic phases in BC, Canada.MethodsAn anonymous online survey about sexual health service needs and access was administered from July 21-August 4, 2020 to clients ≥ 16 years old who had visited the BC Centre for Disease Control’s sexually transmitted infections (STI) clinic and/or GetCheckedOnline testing service in the year prior to March 2020. Using logistic regression, we reported univariate odds ratios (OR) with 95% confidence intervals [95% CI] for characteristics associated with unmet sexual health needs (i.e., not accessing needed services) during March–July 2020.ResultsOf 1198 respondents, 59% (n=706;median age: 32 years, 71% White, 47% women, 27% men having sex with men only (MSM)) reported needing sexual health services since March 2020, of which 52% (365/706) did not access needed services. Women (OR=1.37 [1.01–1.86]) were more likely to have unmet sexual health needs, while MSM (OR=0.37 [0.23–0.61]) were less likely to. Participants needing routine STI testing were more likely to report not accessing services (OR=2.49 [1.64–3.79]), whereas those needing birth control (OR=0.48 [0.30–0.75]), HIV pre-exposure prophylaxis (OR=0.39 [0.22–0.66]), or treatment for a new STI (OR=0.40 [0.21–0.76]) were less likely to report not accessing services. Most common reasons for avoiding/delaying service access were: concern about getting COVID-19 while at or traveling to a clinic/lab (249/689, 36%), public messaging against seeking non-urgent healthcare (239/689, 35%), and closure of usual place of service (182/689, 26%).ConclusionBC sexual health service clients experienced numerous barriers in accessing needed sexual health services during the initial pandemic phases. Offering alternative service delivery methods and more nuanced public health messaging may help address the identified barriers to improve access.