Background Sexually transmitted infections (STIs) increase the risk of HIV infection; however concurrent HIV and STI testing may not be available in all clinical settings. In previous work, we showed a high concordance of self vs. provider STI testing. In this study, we evaluated the implementation of STI self-testing among HIV-negative, asymptomatic adults.

Methods Self collected urine, throat and/or rectal swabs for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC), without physical examination, were completed by 514 HIV-negative (rapid HIV test performed on same day), asymptomatic adults at a walk-in clinic in Washington, DC. Sociodemographic and sexual risk behaviour data were collected, and a post-testing satisfaction survey was completed by each individual.

Results The sample included: 413 (80.4%) men and 101(19.6%) women. The median age was 30 (range 15–72) years. Among the men: 135 (32.7%) African-American; 211 (51.1%) White; 262 (63.4%) men who have sex with men only; 34 (8.2%) men who have sex with both men and women. Among the women: 74 (73.3%) African-American; 18 (17.8%) White; 6 (5.9%) women who have sex with women only; 8 (7.9%) women who have sex with women and men. Among men, the prevalence of CT was 10.7% (2.7% throat, 5.8% rectal and 3.4% urine); for GC 8.5% (6.5% throat, 3.4% rectal and 1.2% urine). Among women, the prevalence of CT 12.9% (4.9% throat, 8.9% rectal and 8.9% urine); GC 3.0% (1.0% throat, 3.0% rectal and 1.0% urine). 95.9% of the individuals reported high acceptance of self-testing with 97.6% willing to do repeat testing and 96.7% to recommend self-testing to someone else.

Conclusion HIV-negative, asymptomatic adults testing for HIV are infected with other STIs. Self-testing for CT and GC was implemented successfully among men and women. Self-testing can mitigate HIV infection by increasing detection and treatment of STIs amongst those seeking HIV testing only.