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Sex Transm Infect 83:286-291 doi:10.1136/sti.2006.023762
  • Screening

Home screening for sexually transmitted diseases in high-risk young women: randomised controlled trial

  1. Robert L Cook1,
  2. Lars Østergaard2,
  3. Sharon L Hillier3,
  4. Pamela J Murray4,
  5. Chung-Chou H Chang5,7,
  6. Diane M Comer7,
  7. Roberta B Ness3,6,
  8. for the DAISY study team
  1. 1Departments of Epidemiology and Biostatistics and Medicine, University of Florida, Gainesville, Florida, USA
  2. 2Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
  3. 3Department of Obstetrics, Gynecology and Reproductive Health Services, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  4. 4Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  5. 5Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  6. 6Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  7. 7The Center for Research on Health Care, University of Pittsburgh, Pittsburgh Pennsylvania, USA
  1. Correspondence to:
 Dr R L Cook
 Department of Epidemiology and Biostatistics and Medicine, University of Florida, Box 100231, Gainesville, FL 32610, Florida, USA; cookrl{at}phhp.ufl.edu
  • Accepted 24 January 2007
  • Published Online First 14 February 2007

Abstract

Objective: Home screening tests could eliminate several barriers to testing sexually transmitted diseases (STDs).

Aim: To determine whether offering repeated home screening tests would increase the rate of testing for chlamydia and gonorrhoea in a high-risk sample of young women.

Methods: In this randomised controlled trial, 403 young women (mean age 18.9 years, 70% black) with a recent STD or with STD-related risk factors were enrolled. Participants were recruited from clinics and high-prevalence neighbourhoods and then randomly assigned to receive either a home testing kit or an invitation to attend a medical clinic for testing at 6, 12 and 18 months after enrollment. Over 80% of women were followed for 2 years. The trial is registered with ClinicalTrials.gov, number NCT 00177437.

Results: Of 197 women in the intervention group, 140 (71%) returned at least one home test and 25 of 249 (10%) home tests were positive. Women who received home screening tests completed significantly more STD tests overall (1.94 vs 1.41 tests per woman-year, p<0.001) and more STD tests in the absence of symptoms (1.18 vs 0.75 tests per woman-year, p<0.001). More women in the intervention group completed at least one test when asymptomatic (162 (82.2%) vs 117 (61.3%), p<0.001). The intervention was most effective among women recruited outside medical clinics. There was no significant difference in the overall rate of STDs detected.

Conclusions: Home screening significantly increased the utilisation of chlamydia and gonorrhoea testing in this sample of high-risk young women, and thus represents a feasible strategy to facilitate STD testing in young women.

Footnotes

  • Competing interests: None declared.

  • Contributors: RLC participated in the design of the study, monitoring of procedures, data analysis, interpretation of findings and writing of the manuscript. LØ participated in the design of the study, interpretation of findings and writing of the manuscript. SLH participated in the design of the study and overseeing of laboratory issues involving home testing. PJM participated in the design of the study, interpretation of findings and writing of the manuscript. CCC conducted data analyses and provided statistical advice. DMC conducted data analyses and contributed to the writing of the manuscript. RBN participated in the design of the study, monitoring of procedures, data analyses, interpretation of findings and writing of the manuscript.

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