204175 Use of the internet and self-collected samples as an STD intervention in rural Illinois counties

Tuesday, November 10, 2009: 9:20 AM

Wiley D. Jenkins, PhD, MPH , Family and Community Medicine, Southern Illinois University School of Medicine, Springfield, IL
Charlie Rabins, MPH , Sexually Transmitted Diseases section, Illinois Department of Public Health, Springfield, IL
Charlotte Gaydos, DrPH , Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD
Mathilda Barnes , Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD
Background Reported chlamydia infection rates have increased twelve of the past thirteen years in Illinois. With significant morbidity, and costs in excess of $1 billion nationally, new interventions must be devised and tested.

Objective To test the utility of Internet-provided self-obtained sample (SOS) kits via www.iwantthekit.org.

Methods Internet access was made available in 25 Illinois counties. Individuals accessing the website were given information concerning STDs and allowed to request a SOS kit. Samples were returned by mail for analysis and results were available by telephone. There were no costs to participants.

Results Data from kits were compared to those from traditional screening methods obtained from the same counties and time period. Positivity rates between methods did not significantly vary by race and/or gender. The Internet method attracted greater participation by males amongst all samples (37.5% of Internet tests versus 25.2% traditional; p = 0.023) and all samples submitted by Whites (40.9% of Internet versus 18.7% traditional; p = 0.000). Of all males, Whites constituted a majority proportion using the Internet but a minority via traditional (81.8% versus 45.6%; p = 0.001). The increase in male participation caused the distribution of Race by Gender to become insignificant for Internet users (chi-square p = 0.205) versus traditional methods ( p = 0.000).

Conclusions We find that the Internet method is effective in reaching a greater proportion of males, without a concurrent loss in prevalence. Continuing work will seek to obtain greater participation by black males who are underrepresented.

Learning Objectives:
1. Describe how the internet and self-collected samples can offer a novel intervention method. 2. Describe the impact and usefulness of such an intervention in Illinois. 3. Discuss some of the limitations of this methodology and how they may be overcome.

Keywords: STD, Intervention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a PhD and MPH in public health, am an assistant professor at the Southern Illinois University School of Medicine, and have studied STD epidemiology for my PhD and the past two years with multiple peer-reviewed presentations and a publication.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.