Abstract
BACKGROUND: Digital testing services for sexually transmitted and blood-borne infections (STBBI) are becoming more common in Canada. There is little evidence supporting the assumption that these services reduce healthcare system burden. To explore this further, we described patterns of provider-based testing among repeat users of a digital STBBI testing service, and their association with access barriers. METHODS: We conducted a cross-sectional survey in November 2022 of repeat GetCheckedOnline.com users (≥2 tests, with 1 test between April and October 2022). We stratified participants into three use patterns of GetCheckedOnline for testing, using ordinal logistic regression to examine associations with barriers reflecting availability, accessibility, acceptability and appropriateness of health services (applying weights to adjust for non-responders). RESULTS: Of 798 participants (17.2% of 4633 eligible), 52.6% only and 35.8% mostly tested through GetCheckedOnline; 14.5% tested more often/equally through healthcare providers. Availability was associated with greater use of GetCheckedOnline (e.g., not having a primary care provider, OR 2.03, 95% CI [1.52-2.73]), and appropriateness with lower use (getting tested part of clinical care, OR 0.07 95% CI [0.05-0.11]). Participants < 25 years, high school educated or less or born outside Canada reported greater use of GetCheckedOnline for testing while 2S/LGBTQ+ and full-time employed participants reported lower use. Most participants (88.0%) would have tested through a provider if GetCheckedOnline were not available. CONCLUSION: GetCheckedOnline use was associated with barriers to the availability of provider-based testing. Digital STBBI testing services may improve access to testing and reduce demands on healthcare providers for testing.