Article Text

Original research
‘To be on the safe side’: a qualitative study regarding users’ beliefs and experiences of internet-based self-sampling for Chlamydia trachomatis and Neisseria gonorrhoeae testing
  1. Maria Grandahl1,
  2. Margareta Larsson1,
  3. Björn Herrmann2
  1. 1Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
  2. 2Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
  1. Correspondence to Dr Maria Grandahl; maria.grandahl{at}


Objectives In Sweden, an increasing number of tests for sexually transmitted infections are conducted. Self-sampling services are provided free of charge at the national eHealth website. Our aim was to obtain a deeper understanding of users’ beliefs and experiences of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) self-sampling services.

Methods This qualitative study is part of the national project ‘Internet-based chlamydia and gonorrhoea self-sampling test’, conducted in Sweden. Individuals ordering a CT/NG self-sampling test at home from the eHealth website were invited to participate. Of the 114 individuals who agreed, a purposeful sample including 20 women and men aged 18–49 years (mean, 30.8 years) participated in a telephone interview in 2019.

Results The test service for CT/NG was highly appreciated by men and women of different ages. Round-the-clock accessibility, avoiding clinical visits, ease of use, confidentiality and a rapid test result were reasons for this appreciation. Language, uncertainty about the correct sampling procedure, unreliable postal services and concerns about handling of personal data were mentioned as barriers. Reasons for testing were checking after unprotected sex, symptoms, checking a partner’s fidelity or a regular routine—‘to be on the safe side’. Knowledge about the infections and their consequences was limited; some considered them severe, especially if they could threaten fertility, and others were less concerned. Disclosing an infection was described as emotionally stressful. Participants had high self-efficacy in relation to the test and would not hesitate to use the service again, even if it involved a cost.

Conclusions Internet-based CT/NG self-sampling at home was highly appreciated and was used for individual health reasons, but also out of concern for others’ health and for society as a whole. The benefits seem to outweigh the barriers, and the service may therefore continue to be widely offered.

  • public health
  • qualitative research
  • infectious diseases
  • sexual medicine
  • reproductive medicine

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Correction notice This article has been corrected since it first published. The provenance and peer review statement has been included.

  • Contributors MG, ML and BH designed the study; BH was responsible for data collection; and MG and ML conducted interviews, carried out the analysis and composed the initial manuscript. All authors contributed to the finalisation of the manuscript.

  • Funding The study was funded by the Public Health Agency of Sweden in 2018; no specific funding number is available. The funders of the study had no role in study design, data collection, data analysis, data interpretation or the writing of the report.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.