New cases of chlamydia, gonorrhea, and syphilis set a record high in 2016. Yet, the rate of testing in many at-risk groups for sexually transmitted infections (STIs) leaves much to be desired, writes Kristin Harper in the November issue of Clinical Laboratory News.

A drop in available resources to support STI testing have led to reduced clinic hours and in some cases, even closures. This had made it difficult to schedule appointments to get STI testing. The stigma that surrounds STI testing is another barrier, and it exists among doctors as well as patients. “Most physicians aren’t particularly good at or comfortable with taking sexual histories,” Peter Leone, MD, professor of medicine at the University of North Carolina at Chapel Hill, tells CLN.

Government health labs and other companies have offered up nontraditional, more accessible and private solutions for STI testing that hold the promise of increasing STI test rates. An example of this is Biem, a New York-based start-up that markets itself as a virtual sexual health clinic, connecting patients with physicians who order STI tests based on video consultations. “Clients access their results online, using the secure Biem app, which features an anonymous network that alerts users if one of their partners who also uses the app tests positive for an STI,” Harper writes. The company is seeking to expand to other major U.S. cities in 2018.

Harper also highlights two other internet-based testing services, and GetCheckedOnline. The former provides online selection and purchasing of STI kits to consumers in most states. Meanwhile, GetCheckedOnline invites high-risk individuals to create an online account and determine which STI tests are most appropriate for them.

GetCheckedOnline offers urine testing for chlamydia and gonorrhea, and blood testing for HIV and syphilis. “Patients go to a local lab where blood samples are taken for HIV, syphilis, and hepatitis C testing. While at the lab, clients also self-collect urine or swab samples for chlamydia and gonorrhea testing,” Harper writes. Public health labs analyze the samples. Patients get a call from the STI clinic if the result is positive, and can access negative test results online. uses an in-house CLIA-certified and College of American Pathologists-accredited laboratory to analyze samples. clients can view their results online. In the event of a positive test, state-licensed doctors call patients to discuss results and treatment options.

Public health experts have largely applauded these efforts, although some have concerns about using an STI testing model that limits physician involvement. “I worry there will be instances when people do not understand incubation periods for certain diseases…This may lead to testing too soon after a sexual encounter, and potentially misleading results,” Melanie Yarbrough, PhD, an instructor of pathology and immunology at Washington University School of School of Medicine in St. Louis, Missouri, tells CLN.

Pick up the November issue of CLN and find out what the future holds for these new STI testing models.