Anonymously on the Web – Syphilis Test 2.0

22. January 2008

Wild life in Amsterdam: With an internet portal, the Dutch try to get a grip on the increase of sexually transmitted diseases. The anonymous tool helps with the early diagnosis of syphilis and rapid therapies: A successful example for Public Health 2.0.

The problem is obvious: Whoever catches a sexually transmitted disease with a seedy life usually does not run to the doctor right away. It normally takes quite a while to overcome his weaker self and to be ready to show skin lesions on delicate spots. Just like in Amsterdam: Since 1998 the number of syphilis infections increase from 35 cases to now more than 300 per year, reports Rik Koekenbier of the Amsterdam Health Service at the Mednet 2007 conference in Leipzig/Germany. But what now?

Barrier-free Syphilis-Test is accepted well

The Dutch decided for a remarkably pragmatic project. The analysis is available now: "We have asked ourselves: How do we manage to get more men having sex with other men to test for syphilis", says Koekenbier. The answer: An interactive website. It was made public in the internet by banner advertising directly on those sites concerning the Amsterdam nightlife, in particular those where the local MSM community cavorts. And this is how the website works: Visitors give themselves a nickname allowing them to download a referral letter. With this letter they go to one of the seven listed laboratories where the syphilis test is made fully anonymously. A few days later, the results are online and can be picked up with nickname and password printed on the referral letter. If the test is positive, it is recommended to go and see a doctor and get treatment.
The Amsterdam STD-Outpatient Clinic is named as the primary point of contact which is familiar with the internet testing procedure. But basically the person can see any doctor treating sexually transmitted diseases. "Altogether we had 20,000 visits of the website within a few months. About 1,000 people downloaded a referral letter and every tenth had a check-up", says Koekenbier. And almost all who were tested checked the results online. 14 of the tests were positive and ten patients came to the Outpatient Clinic. The other four perhaps saw another doctor. Since the system is anonymous, this could not be verified.

Those getting the test, often are risk candidates

All in all, the Amsterdam Health Service is very satisfied with the course of the project – as Koekenbier emphasizes. Especially remarkable is that about half of the patients tested positive were in an early stage of the disease. This is about double of the regular patients' collective of the STD clinic. This indicates that it is indeed a whole lot easier for people to use the anonymous online-procedure than to go straight to a doctor. And efficiency leaves little to be desired: After all, every seventh tested person was positive – considerably more than usual during screening tests for syphilis. It seems that it is actually the risk candidates who are "fished out" by the portal and after the experience with it should not stop with that one portal. The Dutch plan to expand the offer to other sexually transmittable diseases such as chlamydia, gonorrhoea and HIV infections. A new portal fort his service is already under construction and will go online in the near future.

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