Where to get tested

Women overwhelmingly preferred to use at-home tests to screen for two of the more common sexually transmitted infections, chlamydia and gonorrhea, according to a new study by researchers at Washington University in St. Louis.

"Women strongly preferred home-based testing over testing in a clinic or a private physician's office," Dr. Jeffrey Peipert and colleagues from Washington University School of Medicine said in the current edition of Obstetrics and Gynecology.

Although at-home tests for sexually transmitted infections are not currently available in the United States, the study showed that 76 percent of 452 women chose the do-it-yourself method compared with 16 percent who preferred going to a clinic and 6 percent who said they would see a private doctor.

The U.S. Centers for Disease Control currently recommends that women ages 25 and younger receive annual screening for sexually transmitted infections, yet only 26-60 percent of at-risk women in the United States do so.

Dr. Melissa Gilliam, an associate professor of  OB/GYN and pediatrics at the University of Chicago, said some women do not get tested as often as they should because they do not have access to health insurance.

Others avoid screening out of fear. “A handful of patients feel like if they don’t know, it doesn’t exist,” said Kai Tao, a midwife and the associate medical director of Planned Parenthood Illinois.

According to the CDC, 1.5 million cases of chlamydia and gonorrhea are reported annually. Since many cases go unreported, the agency estimates that the actual number of cases is closer to 3 million.

Doctors encourage screening because chlamydia and gonorrhea can both be asymptomatic, Gilliam said.

The women who opted to screen themselves at home were twice as likely to complete the test as women who said they would go to a clinic or a private doctor for testing, researchers found.

Women who chose home-based testing were mailed a collection kit in a plain brown box with detailed instructions for collecting a vaginal swab, packaging and mailing the specimen back to the lab. Nearly all of the women who self-tested reported that the test was easy to perform.

Among the 228 women who were tested, six cases of chlamydia and one case of gonorrhea were found. Four cases of chlamydia and the lone case of gonorrhea occurred in women participating in home-based testing.

Participants who tested positive for a sexually transmitted infection were provided with treatment for themselves and any sexual partners they had.

Researchers reported that test results were similar to those from regular screenings.

Of the women using the home-based test, 97 percent stated that they would undergo testing more frequently if self-testing were available.

Still, some health care professionals are concerned about how viable of an option at-home screening methods are.

According to Gilliam, at-home tests for chlamydia and gonorrhea have potential, but concerns about how infected women would be treated still exist. “From my perspective, the idea of offering different ways of testing is really important, but we would need more information about whether people would follow up before it is ready for widespread approach,” she said.

Others fear at-home screening would detract from the valuable doctor-patient relationship. “There is something really important about having face-to-face encounters with a patient,” Tao said. “There might be other issues that we aren’t talking about.”