MyCheck, a novel e-testing pathway combining telehealth consultation with direct referral to pathology, was well-received by clients and effective as an STI screening and management testing pathway, though staff offer rates to eligible clients were a limiting factor.
Key Findings
Results
Staff offered MyCheck to only 9.8% of eligible asymptomatic clients during the pilot period.
Staff offered MyCheck to 718 out of 7,340 eligible clients (9.8%)
The pilot ran at Sydney Sexual Health Centre (SSHC) between June 2021 and February 2022
SSHC is described as the largest publicly funded urban sexual health clinic in New South Wales
Staff initiated MyCheck offers to asymptomatic clients without complex care needs
The low offer rate was identified as a limiting factor for the program
Results
Approximately two-thirds of clients who were offered MyCheck accepted, and two-thirds of those who accepted attended a pathology collection centre.
472 out of 718 clients who were offered MyCheck accepted (approximately 65.7%)
315 out of 472 clients who accepted attended a pathology collection centre (approximately 66.7%)
MyCheck integrated telehealth assessment with electronic referrals to over 500 pathology centres
The system included automated result entry into the clinic's patient management system
Results
Females were more likely than males to accept the offer of MyCheck testing.
Relative risk for females accepting MyCheck compared to males: RR 1.2 (95% CI: 1.1–1.4)
This was a statistically significant finding based on the confidence interval excluding 1.0
Results
Clients who had arrived in Australia more than 10 years ago were more likely to accept MyCheck testing compared to more recent arrivals.
Relative risk for clients arriving more than 10 years ago vs. recently arrived: RR 1.2 (95% CI: 1.0–1.4)
This suggests length of time in Australia may influence uptake of e-testing pathways
Results
Clients on HIV Pre-Exposure Prophylaxis (PrEP) were less likely to accept MyCheck testing compared to clients not on PrEP.
Relative risk for PrEP clients accepting MyCheck vs. non-PrEP clients: RR 0.8 (95% CI: 0.6–1.0)
PrEP clients may have existing regular testing arrangements through their PrEP management, which could explain lower uptake
Results
17.8% of clients who attended a pathology collection centre received a positive STI diagnosis.
56 out of 315 pathology visits resulted in a positive STI diagnosis (17.8%)
Diagnoses included: 40 cases of chlamydia, 26 cases of gonorrhoea, 3 cases of Mycoplasma genitalium, and 1 case of early latent syphilis
All diagnoses were linked to treatment
The total number of positive diagnoses (70) exceeds the number of positive clients (56), indicating some clients had multiple infections
Results
The majority of MyCheck survey respondents rated the service highly on location of pathology collection centres, quick test turnaround, and appointment availability, but only approximately 50% rated support for questions, safe and stigma-free environment, and familiarity highly.
High ratings were given for location of pathology collection centres, quick test turnaround, and appointment availability
Only approximately 50% of clients rated highly on support for questions, safe and stigma-free environment, and familiarity
These lower-rated dimensions suggest areas where e-testing pathways may fall short compared to in-person clinic visits
Evaluation was based on both clinic data and client surveys
Background
MyCheck was developed to enhance access to STI testing by combining a telehealth consultation with direct referral to pathology, avoiding the need for in-person clinic visits.
MyCheck integrated telehealth assessment with electronic referrals to over 500 pathology centres
The system used automated result entry into the clinic's patient management system
It was designed for asymptomatic STI testing in at-risk populations as recommended by Australian guidelines
The pathway targeted clients without complex care needs
What This Means
This research describes and evaluates MyCheck, a digital sexual health testing service piloted at Australia's largest public sexual health clinic in Sydney. MyCheck allowed people to get tested for sexually transmitted infections (STIs) without visiting the clinic in person — instead, they had a telehealth (phone or video) consultation and then went to one of over 500 nearby pathology collection centres for their samples. Results were automatically sent back to the clinic. The pilot ran from June 2021 to February 2022 and targeted people who had no symptoms and no complex medical needs.
The study found that while MyCheck was generally well-received by clients who used it, the biggest barrier was that clinic staff only offered it to about 1 in 10 eligible clients. Of those who were offered MyCheck, about two-thirds accepted, and two-thirds of those actually went to get tested. Among people who were tested, nearly 1 in 5 received a positive STI diagnosis (most commonly chlamydia or gonorrhoea), and all were linked to treatment. Women and longer-term Australian residents were more likely to accept the offer, while people already using HIV prevention medication (PrEP) were less likely to accept — likely because they already have regular testing routines. Clients rated MyCheck highly for convenience features like nearby collection locations and quick results, but around half felt the service could do more to address questions, reduce stigma, and feel familiar.
This research suggests that digital STI testing pathways like MyCheck can successfully identify and treat infections in people who might not otherwise visit a clinic, making them a valuable tool for expanding access to sexual health care. However, for such programs to reach their full potential, strategies are needed to encourage healthcare staff to offer these services more consistently to eligible patients. The findings also highlight that digital services may need to work harder to replicate the supportive, non-judgmental environment that in-person clinics can provide.
Patel P, Carrington N, Lu H, Lafferty L, Ryder N, Slattery C, et al.. (2025). Evaluation of a novel comprehensive sexual health e-testing pathway to inform state-wide roll out in new South wales, Australia.. BMC infectious diseases. https://doi.org/10.1186/s12879-025-11379-3