Effectiveness of text messages from general practice to increase testing for sexually transmitted infections via an online postal testing platform (Texting for Testing)

Sexually transmitted infections (STIs) can have long-term negative effects on health. The number of people with STIs in Wales and England has increased in recent years. Travel distances and stigma can put people off testing in a sexual health clinic. Free online STI postal testing is available in some parts of the UK including Wales. However, awareness of this service is low, particularly amongst people who do not usually access sexual health services. 

Text messages aiming to encourage testing have mainly been targeted at high-risk groups. While these can help people at higher risk of STIs, evidence of their effects when delivered to a wider population is limited. In a pilot study, we asked GPs to send a text message to all their patients aged 16+ encouraging them to get a test using an online postal STI testing service. We found that this was acceptable to patients and tests were requested by people who were otherwise not accessing testing services. Whether this universal signposting approach is scalable and can increase STI testing across Wales remains unclear. 

We aim to determine, i.) whether a text invitation to all patients aged over 16 from a GP practice to a free online STI postal testing platform increases the uptake of STI tests, ii.) the effectiveness of the intervention on increasing the number of people detected with an STI; iii.) what the experiences and views are of those sending texts, receiving texts and those who have used the testing platform. 

We plan to enrol GP practices across four health boards in Wales and ask them to send a text message to all their patients aged 16+. We have developed the wording of our text message based on psychological theory and input from various stakeholders, including members of the public. We will then obtain anonymised data from Public Health Wales to determine whether there has been a change in testing and diagnoses after the texts have been sent. 

Additionally, we will collect survey data and interview people who have received the text message and accessed the online STI testing system and obtain anonymised information from GP practices about the sorts of questions or concerns their patients may have had about the text message. 

We have a PPI co-applicant and we have shaped this application with their help and following feedback from two separate PPI groups. If funded, we will establish a stakeholder engagement group to help improve the delivery, dissemination, and impact of this research This work will directly inform the Wales HIV Action Plan which seeks to increase access to testing services and reduce stigma around testing. The research will also directly impact testing programmes across the UK and internationally where online testing exists.