PL09 Digital sexual health: what we know and what we need to know for effective services

Estcourt, C.

Many countries’ health strategies promote a large scale shift to digital and self-managed care to meet the population’s health needs. Sexual health services have been at the forefront in some countries, offering an increasing proportion of care remotely through a variety of mixed online and in person clinical care pathways. This shift has probably accelerated during the Covid-19 pandemic when face-to-face care has been actively discouraged, and digital care is at the heart of many countries’ recovery plans.Much innovation in digital sexual health has focussed on postal self-sampling for STIs and blood borne viruses. The available literature, with some exceptions, suggests these services appeal more to women, people with higher educational qualifications, and those from more affluent areas. A recent study suggests that people with mild learning disabilities find considerable barriers to this type of care. Where available, clinical outcomes of online care compare variably with traditional care pathways and there has been little robust economic evaluation.Digital sexual health has huge potential to meet the needs of people who are willing and able to engage with online care. Much more ambitious care could be provided in seamless eClinics which are integrated with face-to-face services, giving the user and health care professional flexibility, continuity and choice. They have the potential to provide good value for money.However, STIs, like digital literacy are socially patterned;the burden of STIs is disproportionately borne by those who already experience health inequalities and people experiencing health inequalities are less digitally and health literate. We need to ensure we create digital health systems which narrow rather than widen existing health divides, and evaluate them robustly.I will summarise existing evidence for online sexual health care and draw out the major evidence gaps to help us develop inclusive, effective online sexual health care.