Objectives Self-testing and point-of-care (POC) tests could improve the detection of sexually transmitted infections (STIs) in adolescents. This study aimed to (1) validate a scale measuring acceptability of self-testing for trichomoniasis, (2) compare acceptability of self versus clinician testing using a POC test for trichomoniasis, (3) examine changes in acceptability after experience and review of results, and (4) examine predictors of acceptability.
Methods Women (14–22 years old) performed the POC test and completed surveys assessing acceptability of self and clinician testing at baseline, after testing, and after discussion of results. Factor analysis examined scale structure; changes in mean scale scores were assessed with mixed models. Generalised linear models examined predictors of acceptability.
Results Of 247 participants, 54 (22%) had a positive POC test for trichomoniasis. Factor analysis confirmed four acceptability subscales: trust of results, confidence, comfort, and effects of testing. At baseline, trust and confidence were higher, and comfort was lower, for clinician versus self testing. For self-testing, all subscale scores increased from baseline to after testing, and trust increased from after testing to after discussion. Trust of self and clinician results was not significantly different after discussion. A positive attitude towards home testing predicted higher self-test acceptability on all subscales. Tampon use was associated with increased self-test comfort at baseline. Concordance between self and clinician results predicted increased trust of self testing after discussion.
Conclusions Many young women lack confidence in their ability to self-test for trichomoniasis. Allowing women to try a POC test and review the results with a clinician increases acceptability of self-testing.
- sexual health
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Funding The study was supported by grant number K23AI063182 (to JSH, principle investigator) from the NIH/NIAID and by grant number 1U54EB007958 (to CAG, principle investigator) from the NIH/NIBIB.
Competing interests JH has received funding (honoraria and reagents) from Genzyme Diagnostics (Cambridge, MA) and from Gen-Probe, Inc.(San Diego, CA). All other authors report no competing interests.
Patient consent Obtained. CCHMC IRB approved consent forms were signed by the patients. The IRB approved a waiver of the requirement for signature of parent because of a risk of breach of confidentiality regarding sensitive material of the study.
Ethics approval The study was reviewed and approved by the institutional review board of Cincinnati Children's Hospital Medical Center.
Provenance and peer review Not commissioned; externally peer reviewed.