App With Quicker STI Test Results Can Help Cut Disease Transmission

By Lorraine L. Janeczko

November 27, 2016

NEW YORK (Reuters Health) - An app that reports positive sexually transmitted infection (STI) test results on a patient's smartphone or computer days before a provider calls them cuts the time during which they may unknowingly infect someone else, a new study suggests.

"Chlamydia, gonorrhea, and syphilis rates among men in the United States are high and increasing, and we can reduce the time that people who test positive live without knowing they are infectious by about two days," Dr. Adam Cohen, Director of Advocacy and Policy Research at the AIDS Healthcare Foundation (AHF) in Los Angeles, told Reuters Health. "But they need to take precautions not to spread infection before being treated."

Dr. Cohen discussed the impact of adding the proprietary platform Healthvana to the AHF STI test notification system in a talk September 21 at the Centers for Disease Control and Prevention 2016 STD Prevention Conference in Atlanta, Georgia.

"This is one of the first studies on STI notifications and smartphone applications. Many studies focus on text messaging, but . . . Healthvana . . . provides a smartphone app you can download to your phone right now and get tested, get your test results and share them with your sexual partners," he said in his talk.

Formerly, AHF clients who tested positive were being given their test results by phone call, Dr. Cohen said. In 2014, however, AHF collaborated with Healthvana Inc, to use their patient engagement platform to notify clients of STI test results.

"Instead of receiving a telephone call that tells them they need to come in and be treated, they get their results instantaneously the moment the lab has their results online. The lab sends that information to a clinic and it also sends it to Healthvana, which immediately send the results to the client. The client is given the test results faster than ever before," Dr. Cohen said in his talk.

To compare time to treatment between clients who had received results by phone and those who now get their results through Healthvana, Dr. Cohen conducted a cross-sectional analysis of 1,460 male clients who received STI testing services in 2014 and 2015, tested positive for chlamydia, gonorrhea, or syphilis, were notified of their positive test results, and returned for treatment.

Over 60% of the clients were under the age of 30. Before AHF made the app available, 779 clients had a mean of 12.55 days between test and treatment; after the app was implemented, in 681 clients, the average was 10.68 days between test and treatment.

Running an ordinary least squares regression, with use of the app, the time from test to treatment fell by 1.87 days (p<0.05); the period from test to notification dropped by 1.95 days (p<0.05); but time from notification to treatment remained unchanged.

On Poisson regression, the number of days from test to treatment decreased by 15% (p<0.05); the time from test to notification dropped by 22% (p<0.05); and the time from notification to treatment increased by 2% (p=0.084).

A limitation to the study was the exclusion of clients who did not return to the AHF clinic for treatment and who may have been treated elsewhere.

Dr. Cohen is exploring how Healthvana can be integrated with social media apps such as Grindr and Tindr, to make test results readily available. He is also considering further study of whether clients who receive results by phone and visit AHF for personal services differ from those who receive results from the smartphone app. He wonders: "Would they need the personal touch of a phone call to get them to come in for treatment?"

Dr. Sheena McCormack, of the University College London, Chelsea and Westminster Hospital in London, who was not involved in the study, said in an interview, "Chlamydia, gonorrhea, and syphilis are increasing universally and we need to take advantage of technological advances like this app to bring transmission rates down."


2016 CDC STD Prevention Conference.


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