S08.2 Self-testing and e-STI: the Dutch experience with home-based and internet-based services and transformation into effective implementation

Abstract

The main STI-healthcare providers in the Netherlands are GPs and sexual health clinics (SHCs). SHCs offer free-of-charge STI-care for key-populations. At the same time, Internet-based STI-test and home-sampling offers increase, offering new opportunities for a blended, more efficient, low threshold service. Currently, SHCs and national partners are reshaping sexual healthcare for young people and other key-populations, using a stepped-care model (SCM). The SCM is based on the principal that not all individuals need the same level of STI-care: some may be helped by online self-assessment tools (sense.info, Advies.chat) and a home sampling-kit and others need support by a professional. NoMoreC and Limburg4zero are regional e-STI services for MSM, developed by SHCs, and co-created with MSM communities, healthcare professionals and other stakeholders, based on a scientific/theoretical framework. NoMoreC targets high-risk MSM for HCV-prevention and offers anonymous, low cost, home-sampled HCV-testing. Limburg4zero provides home-sampling for HIV/STI testing as an extension of regular STI-care including peer-to-peer sharing, and e-counselling on e.g. chemsex and PrEP. Opportunities Community involvement is essential to reach the right target groups Personalized e-STI advice and test-options provide a viable alternative for those preferring autonomic testing, and can saves costs The HCV-test service appeared especially suitable for MSM using PrEP who arrange their own STI-care e-STI should deliver prevention messages for those who tested negative Challenges Quality assurance of test procedures (e.g. quality of the test, which test is offered) is a topic that should be high on the agenda Implementation is only effective when based on a clear theoretical/scientific framework Sustainability of regional e-STI initiatives is challenging; most are financed by research grants and broader/sustainable expansion may need governmental funding Tracking linkage-to-care is challenging in interventions with anonymous participation Return rates of home-sampling kits may be improved through digital innovations