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

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.