Abstract

Objective: Home screening tests could eliminate several barriers to STD testing. We sought to determine whether offering repeated home screening tests would increase the rate of testing for chlamydia and gonorrhea in a high-risk sample of young women.

Methods: In this randomized controlled trial, we enrolled 403 young women with a recent STD or with STD- related risk factors (mean age 18.9 years, 70% black). Participants were recruited from clinics and high- prevalence neighborhoods 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%) of 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 of medical clinics. There was no significant difference in the overall rate of STDs detected.

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