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Digital tech is helping to address inequalities in sexual health testing

By Dr Vanessa Apea, NHS Sexual Health Consultant and Medical Director at Preventx



This week marks HIV Testing Week, an important moment for us to reflect on progress made in tackling HIV, whilst also recognising the need for more work to completely eradicate it.

In England, our collective ambition is to stop HIV transmission by 2030, and to achieve this we need to encourage everyone who is sexually active to test regularly.

Despite the hard work of staff in clinics, I know from my experience it can be difficult for in-person sexual health services to engage with certain communities and to get them to test.

There are many reasons for inequalities in access, with many interconnecting factors that can be difficult to unravel.

One of the fundamental barriers to access is stigma, particularly stigma related to sexual expression and sexually transmitted infections (STIs), which leaves many people feeling too uncomfortable or embarrassed to seek help.

Other commonly cited barriers can include a lack of awareness of the services available or an inability to find free time to visit clinics – which unfortunately disproportionately affects those with a lower socioeconomic status.

Whatever the reason, inequality is an issue we must address, and the responsibility falls on healthcare providers, commissioners and wider health economy to better define and address these inequities.

Reporting from UK Health Security Agency (UKHSA) shows that the majority (53 per cent) of new UK HIV diagnoses occurred within racially minoritised groups.

While it’s important that everyone who is sexually active tests for HIV, engaging and testing people from more affected communities is particularly vital.

At Preventx, we know that online testing can be an effective way to address this issue and get more people to test – and we can see the impact this is having.

Our data shows that that almost half of people (49 per cent) testing for HIV in 2020 and 2021 were from racially minoritised groups, while national figures show a significantly lower proportion (39 per cent) of the same groups tested through an in-person clinic.

This highlights that at-home testing is an extremely effective way of engaging a broader range of people.

Digital services address some commonly faced barriers to access, such as offering convenience for people unable to find time for in-person appointments or facing geographical barriers.

Online services can also be perceived as a ‘safe’ way to engage with healthcare services for people who are nervous about going to a clinic or conscious of stigmas related to sexual expression and STIs.

This can often act as a stepping-stone to better engagement with in-person services.

When delivered in partnership with the NHS, online testing is an effective, convenient, and confidential way for people to test for HIV.

Our data also shows that overall usage of online HIV testing continues to rise in the UK, with over 540,000 at-home HIV tests expected to be taken before the end of 2022.

With 516,457 online HIV tests taken in 2021, that means more than one million people will have taken an at-home HIV test in the last two years.

The opportunity is clear, and we must now accelerate progress.

Preventx’s fully integrated pathway demonstrates how a comprehensive online sexual health testing service can work.

Our model includes an innovative technology platform, patient self-sampling and an in-house laboratory, where test results are analysed and dispatched.

This system enables our clinical partners to deliver the best standard of HIV diagnostics.

If we are to meet our collective ambition of eradicating HIV, then we need a fully funded sexual health strategy which ensures comprehensive sexual health services, in which in-person clinics work in partnership with at-home online testing services, are available to everyone.

We know that innovative digital services are playing an important role in increasing access, and we must continue developing digital services in tandem with in-person services with equity always in mind, to ensure an accessible and complete offering for all patients.

Preventx is the UK’s largest provider of remote sexual health tests, partnering with the NHS in more than 70 local authority areas.

To find out if a free HIV test kit is available in your area, visit www.sh.uk

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