Incidence of sexually transmitted disease is rising in Amsterdam,
Incidence of sexually transmitted disease is rising in Amsterdam.

The Amsterdam Health Service has announced that it will launch a web based out patient clinic in November. It aims to offer easy access, anonymous screening for people at risk of sexually transmitted diseases (STD).

Project manager Rik Koekenbier presented the plan from the Amsterdam Health Service at the Mednet 2007 conference in Leipzig. Koekenbier reported the details of a pilot website that has been already been offering online syphilis testing for 15 months. “This site was a big success, so we decided that we will extend the scope of the project to Chlamydia infections, gonorrhoea and HIV now”, said Koekenbier. The new site will go live on 1 November 2007.

Incidence of sexually transmitted disease is rising in Amsterdam, especially among the gay population. With Syphilis, for example, where there were 35 infections in 1998, recent figures show the number has risen almost tenfold to around 300. Men who have sex with men (MSM) are at the highest risk of infection by some distance.

“We asked ourselves how to encourage more MSM to get tested”, said Koekenbier. The answer was an interactive tool on the website www.syfilistest.nl. It was promoted by banner advertising, especially in internet forums known to be frequently visited by the Amsterdam MSM community.

The procedure is relatively straightforward: Visitors adopt a pseudonym on the website and are then able to print a referral letter. The letter entitles them to an anonymous, and free of charge, blood sample to be taken at one of seven laboratories. Following this, the laboratory posts the results online where they can be accessed by the patient. Should the test prove positive, the patient is advised to visit an STD clinic for diagnosis confirmation and treatment.

“All in all we had over 20,000 site visits in a few months. Nearly one thousand people downloaded a referral letter, and ten per cent of those got tested”, said Koekenbier. Practically all of these checked their results online. And of those 14 with a positive test result, ten came to one of the recommended STD clinics. The other four might have visited a different doctor and also got treatment, but this could not be verified due to the anonymous testing procedure.

“What is remarkable is that 50 per cent of those tested online have early or latent disease”, said Koekenbier. This is twice as many as among patients of conventional STD clinics, indicating that it is psychologically easier to do the online testing then to go to an STD specialist right away.

“We also did definitely target the right population”, said Koekenbier. Every seventh of those who performed a test was tested positive, far more than usual: “These are not the ‘worried well’ but those who are really at risk of STD.”

It comes as no surprise then that the Amsterdam Health Service is extending the programme to be inclusive of other sexually transmitted diseases. The new website’s launch is planned for November 1st and is to be backed with a high profile media campaign.