ABSTRACT
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.
ABSTRACT
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.