Digital sexually transmitted infection and HIV services across prevention and care continuums: evidence and practical resources
Joseph D. Tucker
A B * , Jane Hocking C , David Oladele D and Claudia Estcourt E F
+ Author Affiliations
- Author Affiliations
A Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
B Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
C Faculty of Medicine, Dentistry, and Health Sciences, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.
D Clinical Research Department, Nigerian Institute of Medical Research, Lagos, Nigeria.
E School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, UK.
F Sandyford Sexual Health Services, NHS Greater Glasgow & Clyde, Glasgow, UK.
Sexual Health - https://doi.org/10.1071/SH22023
Submitted: 8 February 2022 Accepted: 5 May 2022 Published online: 16 June 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing
Abstract
Increased demand for sexual health services (including prevention and treatment) have spurred the development of digital STI/HIV services. Earlier advances in testing technologies opened the door for self-testing and self-sampling approaches, in line with broader self-care strategies. Advances in HIV management mean that many people are living well with HIV and no longer need intensive in-person monitoring, whereas those at-risk of HIV are recommended to have regular asymptomatic STI screening and pre-exposure prophylaxis. This narrative review examines the evidence and implications of digital STI/HIV services, focused on promoting testing, facilitating testing, clinical management and referrals, partner services, and prevention. We have used a prevention and care continuum to structure the review to increase utility to policy as well as practice. Digital STI/HIV services can be interwoven into existing clinical pathways to enhance face-to-face services or standalone digital STI/HIV services. A growing evidence base, including randomised controlled trials and observational studies, should help inform strategies for designing effective digital STI/HIV services. However, most studies to date have focused on high-income countries and people with smartphones, despite a substantial burden of STI/HIV in low- and middle-income countries. There are also important differences between digital STI and HIV services that require careful consideration. We discuss digital STI/HIV service evidence and implications to inform research and programs in this exciting field.
Keywords: chlamydia, clinical, digital, e-health, gonorrhoea, HIV, m-health, partner services, social media, STI.
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