Evidence map›Paper›PMID 41403647›Full record

ArticleThe Lancet regional health. Europe2026

Sexually transmitted infection testing and key outcomes following implementation of online postal self-sampling into sexual health services in England: a retrospective observational study of routinely collected service-level healthcare data.

Jo Gibbs, Oliver Stirrup, Anna Tostevin, Alison Howarth, Claire Dewsnap, Jonathan D C Ross, Andy Williams, Vicky Tittle, Sara Day, Jack Brown and 9 more

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet regional health. Europe, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Jo GibbsUCL Institute for Global Health, Mortimer Market Centre, Off Capper Street, London, WC1E 6JB, UK.
Oliver StirrupUCL Institute for Global Health, Mortimer Market Centre, Off Capper Street, London, WC1E 6JB, UK.
Anna TostevinUCL Institute for Global Health, Mortimer Market Centre, Off Capper Street, London, WC1E 6JB, UK.
Alison HowarthUCL Institute for Global Health, Mortimer Market Centre, Off Capper Street, London, WC1E 6JB, UK.
Claire DewsnapSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Jonathan D C RossBirmingham City University, Birmingham, UK.
Andy WilliamsBarts Health NHS Trust, London, UK.
Vicky TittleChelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Sara DayChelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Jack BrownUCL Institute for Global Health, Mortimer Market Centre, Off Capper Street, London, WC1E 6JB, UK.
David CrundwellLay Representative, London, UK.
Louise J JacksonInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Catherine H MercerUCL Institute for Global Health, Mortimer Market Centre, Off Capper Street, London, WC1E 6JB, UK.
Jessica SheringhamInstitute of Epidemiology and Health Care, University College London, London, UK.
Ann SullivanChelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Andrew J WinterSandyford Sexual Health, NHS Greater Glasgow and Clyde, Glasgow, UK.
Geoff WongNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Andrew CopasUCL Institute for Global Health, Mortimer Market Centre, Off Capper Street, London, WC1E 6JB, UK.
Fiona BurnsUCL Institute for Global Health, Mortimer Market Centre, Off Capper Street, London, WC1E 6JB, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: A shift to online postal self-sampling (OPSS) for sexually transmitted infections (STIs) in high-income settings has occurred. We evaluate whether introduction of OPSS in England is associated with changes in testing activity and if this differs by population characteristics. Methods: A retrospective study of sexual health (online and clinic-based) service-level data, across three case study areas (CSAs) that implemented OPSS at different times, using different models, and whose populations have different socio-demographic profiles, between 01/01/2015 and 31/12/2022 (from 01/08/2014 in CSA1 to ensure 12 months pre-OPSS). The primary outcome was chlamydia/gonorrhoea and HIV testing activity. We evaluated change over time using selected calendar years, with total activity following introduction of OPSS (2019 and 2022) compared to pre-OPSS periods (CSA1, 2014-2015, CSA2 2017, CSA3 2019), and whether outcome changes differed by socio-demographic characteristics. Findings: In all CSAs chlamydia/gonorrhoea and HIV testing activity increased following introduction of OPSS with incidence rate ratios (IRR) for chlamydia/gonorrhoea testing in 2022 compared to pre-OPSS baseline ranging from 2.1 (95% CI 2.1-2.2) in CSA1 to 2.5 (95% CI 2.4-2.5) in CSA3, and for HIV testing from 1.5 (95% CI 1.5-1.5) in CSA1 to 2.8 (95% CI 2.8-2.8) in CSA2. Differences existed across all demographic characteristics in the relative change in testing incidence (all P < 0.0001 for chlamydia/gonorrhoea). Higher testing activity via OPSS was seen among men who have sex with men (MSM), particularly in CSAs1-2 for chlamydia/gonorrhoea (IRR2.9 (95% CI 2.8-3.1) and 3.6 (95% CI 3.5-3.7) in MSM compared to 1.7 (95% CI 1.7-1.8)and 1.8 (95% CI 1.8-1.8) in men who have sex exclusively with women (MSEW) for 2022 Interpretation: Despite a reduction in clinic-based testing linked to COVID-19, the introduction of OPSS has been associated with increases in overall testing activity. OPSS uptake was lower among populations with greater potential for unmet need, such as individuals living in more deprived areas. Although OPSS is available to all people living within the commissioned areas, in practice not all individuals with a need for STI testing are aware of it or have the confidence and ability to access it. Differences across all socio-demographic characteristics in the relative change in testing could inadvertently increase existing inequalities in access to care and it is important to offer choice of mode of testing for service users. Funding: National Institute for Health and Care Research.

Indexed as

Digital healthOnline STI testingSexual healthSTIsSTI service provision

Identifiers

PMID41403647
PMCPMC12704373

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.