Sexually transmitted infection (STI) tests may have increased availability when reducing the cost and addressing concerns among adolescents and young adults (AYA), according to a recent study presented at the Infectious Disease Society for Obstetrics and Gynecology 2024 Annual Meeting.1
Takeaways
- Reducing the cost of STI tests and addressing confidentiality concerns can enhance their availability and uptake among adolescents and young adults.
- The United States has the highest rate of STIs among high-income countries, with half of the cases occurring in individuals aged 15 to 24 years.
- Key barriers to STI testing among youth include the cost of care, access to healthcare services, and concerns about confidentiality.
- The AI tool MySTIRisk has proven effective in identifying high-risk subgroups for STIs, highlighting the potential of technology in improving STI testing and prevention.
- Convenience, cost, privacy, and simplicity are top factors that make home-based STI testing appealing to youth, with many expressing willingness to use mail-in kits and pay under $50 for a test.
Among high-income countries, the United States has the highest rate of STIs, with approximately half of cases occurring in AYA aged 15 to 24 years. Barriers to reproductive health care services among AYA include cost of care, health care access, and confidentiality.
Annual screening for Chlamydia trachomatis and Neisseria gonorrhoeae is recommended in women aged under 24 years by the Centers for Disease Control and Prevention and US Preventative Services Taskforce, but only 53.4% followed this recommendation in 2022. Currently, it is unclear how to best implement home-based STI screening for AYA.
Innovations have been made in STI testing, such as the artificial intelligence tool MySTIRisk, which has been indicated as effective for identifying high-risk subgroups.2 The tool reported high risk in 35% of HIV consultations, 23% of syphilis consultations, 31% of gonorrhea consultations, and 39% of chlamydia consultations.
Investigators conducted a study to evaluate AYA perspectives about STI testing.1 Data was obtained from 5 open-ended questions sent to a national cohort of AYA. Responses were qualitatively coded with coded responses converted into categorical variables.
A response rate of 84.3% was reported. Of respondents, 62.7% were White, 10% Black, 15.3% Asian, and 12% other. The mean age of participants was 19.8 years, and 42.2% were male, 45.4% female, 3.7% transgender, 7% non-binary, and 1.7% other.1
Convenience was the most common factor reported by participants as making home-based STI testing a good option, mentioned by 289 participants. This was followed by cost by 173, privacy by 167, simplicity by 138, accuracy by 74, and efficient testing by 63.
“If it were easy to pick up a kit, say at my local pharmacy or university health service,” said a non-Hispanic, White, female respondent aged 22 years when asked what would make home-based STI testing a good option.
When asked what would prevent them from using a home-based STI test, 168 participants responded with nothing. This was followed by test administration from 156, accuracy from 147, privacy from 131, cost from 119, and accessibility from 79.1
Sixty-five percent of participants said they would be comfortable returning their sample by mail in a pre-paid envelope, while 17% said no and 17% said depends. Among those saying depends, 15% added, “as long as it doesn’t get lost,” 6% said, “if packaging is discrete,” and 2% said, “slower results.”
A willingness to pay for a home-based STI test kit was expressed by 471 participants. Of these, 36 were willing to pay up to $50 to $100, while 208 were willing to pay $21 to $50, 158 were willing to pay $11 to $20, and 77 were only willing to pay under $10.
These results indicate STI test kits should be provided at locations AYAs frequently visit and online. The kits should also cost under $50 or be included in health plans. These initiatives will help make STI test kits more accessible and convenient for use among AYAs.1
References
- Foug K, Pediyakkal H, Parker JN, Waselewski M, Chang T, Mmeje O. Home-based STI test kits: Barriers to use among a nationwide cohort of adolescents and young adults. Presented at: The Infectious Disease Society for Obstetrics and Gynecology 2024 Annual Meeting. Portland, OR. August 1-3, 2024.
- Krewson C. Study finds AI tool MySTIRisk effectively identifies high-risk STI subgroups. Contemporary OB/GYN. March 5, 2024. Accessed August 6, 2024. https://www.contemporaryobgyn.net/view/study-finds-ai-tool-mystirisk-effectively-identifies-high-risk-sti-subgroups
