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Health Equity Analysis of Awareness and Use of GetCheckedOnline, British Columbia’s Digital Intervention for Sexually Transmitted and Blood-Borne Infection Testing in 5 Urban, Suburban, and Rural Communities: Cross-Sectional Survey Study

Background: Digital sexually transmitted and blood-borne infection (STBBIs) testing services are used to improve testing access, but might replicate existing social inequities. Previous research has shown that the digital STBBI testing service has improved access to testing in British Columbia (BC), Canada. As part of the program’s continuous evaluation, we examined awareness and use of the service in 5 urban, suburban, and rural communities where the program has expanded. Objective: This study aimed to determine if social location is associated with differences in awareness and use of the service in 5 communities outside Vancouver, BC. Methods: From July to September 2022, we conducted a cross-sectional survey recruiting (in-person and online) sexually active people aged 16 years or older in 5 urban, suburban, and rural communities where had sample collection sites available at the time. We examined differences in awareness and use by age, gender identity, sexual identity, race/ethnicity, education, and income using logistic regression models informed by the Health Equity Measurement Framework. Results: Of the 1658 participants (n=1058, 63.8% in-person and n=600, 36.2% online), 35.3% (586/1658) were aware of and 19.5% (324/1658) had used it. Awareness and use were lower in the first and last age quartiles compared to the second quartile (>38 years: awareness odds ratio [OR] 0.23, 95% CI 0.17‐0.32; use OR 0.19, 95% CI 0.12‐0.28;
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