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Table 2 Recommendations for the development of STI self-testing within online care pathways

From: Young people’s perceptions of smartphone-enabled self-testing and online care for sexually transmitted infections: qualitative interview study

Theme Recommendations for development
Making access to STI testing quicker, easier and more convenient The amount of information users need to input should be kept to a minimum.a
The device should be easy to use.
‘Faceless’ sexual healthcare Face-to-face contact with health service staff should be minimised.b
Concealing use of sexual healthcare The self-testing device needs to look inconspicuous (size, appearance).
The content and sender name of electronic communications (text messages, emails) should make no reference to STI testing or use of sexual healthcare.
An app downloaded to the phone may compromise privacy, so alternatives should be explored.
Speed of testing The test should give results faster than conventional services, but not necessarily very rapidly.c
Self-testing with new technology vs. professionals testing using established technology Accuracy of results is very important.
Accuracy is a concern with self-operation of novel testing technology (ways to increase confidence in the accuracy of the device, and minimise wasteful repeat-testing, need further exploration).
Personal support from healthcare professionals Optional support from a health professional should be available.d Given the concern for privacy and convenience, this could be by telephone.
Legitimacy and credibility Confidentiality should be assured.
It should be clear to users that the service is part of the NHS.
Confidentiality, data security and trust It should be clear to users that the service is part of the NHS.
Passwords, assurances that the system is secure, and legitimacy (above) aid trust in data security.
Concealing evidence of an STI The design of the device and care pathways should enable users to keep all evidence of STI secret (including: results message, prescription, treatment)
Convenience/discretion of postal receipt of treatment was preferred by some, while others preferred the speed and privacy (from household members) of collecting treatment from community pharmacy.
  1. aThis needs to be balanced with clinical and disease surveillance requirements
  2. bWhere medically-appropriate for individuals, and preferred. See also ‘Personal support from healthcare professionals’
  3. cDiverse views were expressed, with some perceiving a very fast result to be less accurate
  4. dThe need for a helpline from a clinical perspective had already been established, but this research confirmed its importance to potential users and its role in providing emotional support