At-Home STI Testing Highlights New Patient Target

TOPLINE:

Asymptomatic sexually transmitted infections (STIs) screening delivered by mail has a high return rate, and helps identify increased odds for chlamydia and gonorrhoea positivity among unique groups (trans women, trans men, and non-binary).

METHODOLOGY:

• A retrospective evaluation of routinely collected Sexual Health London (SHL) clinical service data from January 8, 2021, to March 31, 2022 focusing on HIV, chlamydia, and gonorrhoea and including completed consultation forms and STI test kit orders.
• Analyses included uptake of each SHL clinical care pathway stage.
• Binary logistic regression was used to examine association between explanatory variables (SHL user-completed online consultation) and chlamydia, gonorrhoea nucleic acid amplification test (NAAT) outcomes.

TAKEAWAY:

• Overall, 1,476,187 orders were completed by 670,293 unique users; 79.5% of returned samples for NAATs were for gonorrhoea, 79.5% for chlamydia, and 67.6% for HIV.
• Chlamydia and gonorrhoea NAAT positivity result was 4.5% and 1.6%, respectively.
• Adjusted odds ratio (aOR) demonstrated, compared with cisgender women, that greatest likelihood for positive chlamydia test results in cisgender men (aOR, 1.31; 95% CI, 1.28-1.34), trans women (2.63; 2.00-3.47), trans men (1.97; 1.39-2.79), non-binary (1.39; 1.14-1.69), and other gender (1.70; 1.39-2.09).
• A similar trend was seen for gonorrhoea in cisgender (aOR, 1.99; 95% CI, 1.90- 2.07), trans women (4.30; 3.24- 5.71), trans men (2.30; 1.32- 3.17), non-binary (1.72; 1.37-2.16), and other gender (1.38; 1.02-1.87).
• Most affected populations for both were Black, mixed, or other ethnicities.
• Treatment outcomes demonstrated a high uptake of remote chlamydia prescribing (56.7%).

IN PRACTICE:

“Data demonstrate the occurrence of STI testing in populations who have not previously accessed clinic-based sexual health services,” the authors wrote. “Further work is needed to combine clinic-based services with online postal self-sampling services,” they added.

SOURCE:

The study was led by Victoria Tittle, Sexual Health London, London, UK, and appeared online in Sexually Transmitted Infections.

LIMITATIONS:

Limitations included missing data, missing confounders, methodology/inability to make comparisons with clinic-based data.

DISCLOSURES:

The study was funded in part from the City of London. The co-authors reported no financial disclosures of interest.