On October 22, 2026, Kaiser Permanente researchers published a study in Clinical Infectious Diseases (DOI 10.1093/cid/ciag532) showing that a self-service STI testing "e-visit" built into Kaiser Permanente Northern California's patient portal reaches the patients most likely to be infected. The retrospective cohort covered 979,557 adults who completed STI testing between February 13, 2022 and December 31, 2024. Of those, 150,128 (15%) ordered their own tests through the e-visit, a median of 8,822 a month, instead of going through a clinician visit, phone call or message.

Why It Matters

This is the strongest large-scale evidence yet that **removing the sexual-history conversation** at the start of care brings in higher-risk patients rather than "worried well" testers. That supports the whole DTC sexual-health model, from [Everlywell](/stories/everlywell-waters-hpv-self-collection) and [MISTR](/stories/mistr-two-million-free-tests-adap) to [Grindr's new Health tab](/stories/grindr-purposemed-freddie-250m). What separates Kaiser's version from mail-in kits is that testing, results and treatment all stay inside one system, so there is no kit-return problem and no handoff to a pharmacy. Telehealth STI services can borrow the product details directly: opt-out HIV testing, automatic syphilis co-testing, extragenital swabs offered by default, and a PrEP prompt inside the same flow. Independent DTC platforms will struggle to match the closed treatment loop. It also points to who benefits. Payers and integrated systems ([Novant's virtual men's-health clinic](/stories/novant-virtual-mens-health-clinic) is one example) can build this into their portals without paying DTC customer-acquisition costs. At about 9,000 tests a month in one region, the portal is already a large sexual-health front door.

The headline number is positivity. 14.7% of e-visit users were diagnosed with an STI, compared with 2.8% of everyone else (adjusted prevalence ratio 3.31). E-visit users were younger (median age 31 vs 37) and more likely to be male (APR 1.26), Black (APR 1.36) and to have a previous STI diagnosis (APR 2.58). "Telling a doctor about your sex life isn't easy for everyone," co-lead author Dr. Amanda Thornton of The Permanente Medical Group said in Kaiser's release. Co-lead author Dr. Dana Clutter said the e-visits "are reaching the right people."

The design choices are the part other providers can copy. A member answers a short questionnaire at any hour, picks which infections to test for, and lab orders are placed automatically. They then visit any KPNC lab, results go to a physician's inbox, and medication can be collected or mailed. The form automatically co-tests for syphilis, makes HIV screening opt-out rather than opt-in, offers throat and rectal swabs to every user, and lets users learn about and request HIV PrEP. The authors flag one gap: Hispanic and Latino members used the e-visit less than White members, which suggests better Spanish-language outreach is needed. They also note that results may not carry over to less integrated health systems. The study was funded internally by TPMG's Delivery Science and Applied Research Program.

Sources

Update — 2026-10-25

Initial entry — story first created.