Sex Transm Infect 92:44-48 doi:10.1136/sextrans-2015-052058
  • Epidemiology
  • Original article

Use of a risk quiz to predict infection for sexually transmitted infections: a retrospective analysis of acceptability and positivity

  1. Yu-Hsiang Hsieh2
  1. 1Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
  2. 2Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Dr Charlotte A Gaydos, Division of Infectious Diseases, Johns Hopkins University, 855 North Wolfe St., 530 Rangos Building, Baltimore, MD 21205, USA; cgaydos{at}
  • Received 2 March 2015
  • Revised 9 July 2015
  • Accepted 29 July 2015
  • Published Online First 18 August 2015


Background Individuals who are sexually active may want to make a decision as to whether they are at risk for having a sexually transmitted infection (STI) such as Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. Our goal was to develop and evaluate a simple self-taken sexual risk quiz for participants, ordering an online STI self-collection test kit to determine whether the score predicted infection status.

Methods As part of the IWantTheKit programme for home sample self-collection for STIs, 2010–2013, the programme asked male and female users to voluntarily take a risk quiz. The six-question quiz was about risk behaviour and included an age question. Data analyses were stratified by gender as determined a priori. Scores 0–10 were stratified into risk groups for each gender based on similar risk score-specific STI prevalence. Retrospective analyses were performed to assess whether risk group predicted aggregate STI positivity. Urogenital/rectal mailed samples were tested by nucleic acid amplification tests.

Results More females (N=836) than males (N=558) provided voluntary risk scores. The percentage of eligible participants who submitted scores was 43.9% for both females and males. There was a higher STI infection rate in females (14.0%) than in males (7.0%) for having any STI (p<0.001). Multivariate logistic analysis for females, which controlled for age and race, demonstrated that a higher risk score group independently predicted risk for having an STI (OR of 2.2 for risk scores 5–7 and 4.2 OR for scores of 8–10). For males, the multivariate model, which controlled for race, indicated that no risk score group was associated having an STI.

Conclusions Results of a participant's own sexual risk quiz score independently predicted STI positivity for women, but not for men. Further study of this simple risk quiz is required.