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Higgins DM, Moore M, Alderton L, Weinberg L, Hickok AM, Yale A, Wendel KA. Evaluation of a Statewide Online, At-Home Sexually Transmitted Infection and Human Immunodeficiency Virus Screening Program. Clin Infect Dis 2023; 76:2148-2153. [PMID: 36757359 DOI: 10.1093/cid/ciad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/20/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Innovative approaches such as online, at-home programs may address important barriers to sexually transmitted infection (STI) and human immunodeficiency virus (HIV) screening in the United States. This study evaluated the first year of an online, at-home program offering HIV and triple-site (urogenital, rectal, and pharyngeal) gonorrhea (GC) and chlamydia (CT) testing in Colorado. METHODS Test Yourself Colorado (TYC) is an online, at-home program that provides free mailed HIV tests and/or GC/CT tests to Colorado adults. Program use and outcomes between 1 June 2021 and 31 May 2022 were analyzed. RESULTS A total of 1790 unique clients utilized TYC. Of 1709 clients who ordered HIV tests, 508 (29.7%) were men who have sex with men (MSM), and 41.3% (210/508) of these clients reported having never been tested for HIV before or were not tested in the prior year. Hispanic clients had lower STI test return rates (37.1%; 134/361) compared with non-Hispanic clients (45.9%; 518/1128) (P = .003). Positive STI tests were identified in 9.6% (68/708) of clients. Positive STI tests were more common in MSM clients (15.7%; 34/216) compared with all other sexual orientations (6.9%; 34/492) (P < .001). STI treatment was confirmed in 80.9% (55/68) of clients. CONCLUSIONS The TYC online, home testing portal is a scalable tool that reaches clients at risk of STIs and HIV and navigates those with positive STI tests to treatment. HIV/STI home testing programs need to further assess and address utilization and outcomes for disparities by race and ethnicity to assure programs equitably benefit all at-risk communities.
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Affiliation(s)
- David M Higgins
- Public Health Institute at Denver Health, Denver, Colorado, USA
- Preventive Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- Denver Prevention Training Center, Division of HIV/STI Prevention, Public Health Institute at Denver Health, Denver, Colorado, USA
| | - MaShawn Moore
- Public Health Institute at Denver Health, Denver, Colorado, USA
| | - Lucy Alderton
- Public Health Institute at Denver Health, Denver, Colorado, USA
| | - Laura Weinberg
- Public Health Institute at Denver Health, Denver, Colorado, USA
| | - Andrew M Hickok
- Public Health Institute at Denver Health, Denver, Colorado, USA
| | - Andrew Yale
- Public Health Institute at Denver Health, Denver, Colorado, USA
| | - Karen A Wendel
- Public Health Institute at Denver Health, Denver, Colorado, USA
- Denver Prevention Training Center, Division of HIV/STI Prevention, Public Health Institute at Denver Health, Denver, Colorado, USA
- Division of Infectious Disease, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
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Rahib D, Lydié N. Dispositifs de dépistage des infections sexuellement transmissibles à domicile : quelle prise en compte des populations LGBT ? SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 34:179-188. [PMID: 37336732 DOI: 10.3917/spub.hs2.0179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
INTRODUCTION Every days, more than one million people are infected with a sexually transmitted infection worlwide. In France, screening mainly rely on medical laboratories, private or public, with e prescription. Those tests face structural ans social barriers for LGBT people that could be partially lifted using at home self sampling. Using a narrative review, we will study how the needs of those populations are adressed in existing at home self sampling interventions. PURPOSE OF RESEARCH Describe the adaptation of home sampling system to MSM, WSW and transgender peoples. RESULTS Nine interventions met our inclusion criteria, eight in English spoken countries. Studies did not systematically reported data on sexual orientation. Transgender people, when identified, were rarely a larger group enough to be the subject of sub-analysis. Infections tested were CT and NG for three intervention, HIV only for one, CT,NG and HIV for five, and one also add HCV. CONCLUSIONS Standing as a complement to physical testing services, at home self-sampling intervention could benefit from an advertisement to WSW and from the integration of wider sexual health services.
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Melendez JH, Gilliams EA, Yu T, Williford SL, Armington GS, Silver B, Huebner A, Gaydos CA, Manabe YC, Hamill MM. Rapid Uptake of Testing for Chlamydia, Gonorrhea, and HIV From an Online Platform, April-October 2020. Am J Public Health 2022; 112:985-989. [PMID: 35617664 PMCID: PMC9222452 DOI: 10.2105/ajph.2022.306835] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2022] [Indexed: 11/04/2022]
Abstract
The Baltimore City Health Department (Baltimore, MD) promoted IWantTheKit for chlamydia, gonorrhea, and HIV testing to city residents and clinic patients when COVID-19 restricted in-person clinic services. From April to October 2020, monthly online IWantTheKit orders increased by 645%. A high prevalence of chlamydia and gonorrhea was detected, and 96% of users who tested positive for chlamydia and gonorrhea were successfully contacted for treatment. Uptake by Baltimore City Health Department priority populations and excellent treatment linkage demonstrated how a public health-academic partnership successfully addressed a service gap during the pandemic. (Am J Public Health. 2022;112(7):985-989. https://doi.org/10.2105/AJPH.2022.306835).
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Affiliation(s)
- Johan H Melendez
- Johan H. Melendez, Tong Yu, Sarah L. Williford, Gretchen S. Armington, Barbara Silver, Charlotte A. Gaydos, and Yukari C. Manabe are with the Johns Hopkins School of Medicine, Baltimore, MD. Elizabeth A. Gilliams and Matthew M. Hamill are with the Baltimore City Health Department, Baltimore, MD. Adam Huebner is with the Office of Global AIDS Coordination, US Peace Corps, Washington, DC
| | - Elizabeth A Gilliams
- Johan H. Melendez, Tong Yu, Sarah L. Williford, Gretchen S. Armington, Barbara Silver, Charlotte A. Gaydos, and Yukari C. Manabe are with the Johns Hopkins School of Medicine, Baltimore, MD. Elizabeth A. Gilliams and Matthew M. Hamill are with the Baltimore City Health Department, Baltimore, MD. Adam Huebner is with the Office of Global AIDS Coordination, US Peace Corps, Washington, DC
| | - Tong Yu
- Johan H. Melendez, Tong Yu, Sarah L. Williford, Gretchen S. Armington, Barbara Silver, Charlotte A. Gaydos, and Yukari C. Manabe are with the Johns Hopkins School of Medicine, Baltimore, MD. Elizabeth A. Gilliams and Matthew M. Hamill are with the Baltimore City Health Department, Baltimore, MD. Adam Huebner is with the Office of Global AIDS Coordination, US Peace Corps, Washington, DC
| | - Sarah L Williford
- Johan H. Melendez, Tong Yu, Sarah L. Williford, Gretchen S. Armington, Barbara Silver, Charlotte A. Gaydos, and Yukari C. Manabe are with the Johns Hopkins School of Medicine, Baltimore, MD. Elizabeth A. Gilliams and Matthew M. Hamill are with the Baltimore City Health Department, Baltimore, MD. Adam Huebner is with the Office of Global AIDS Coordination, US Peace Corps, Washington, DC
| | - Gretchen S Armington
- Johan H. Melendez, Tong Yu, Sarah L. Williford, Gretchen S. Armington, Barbara Silver, Charlotte A. Gaydos, and Yukari C. Manabe are with the Johns Hopkins School of Medicine, Baltimore, MD. Elizabeth A. Gilliams and Matthew M. Hamill are with the Baltimore City Health Department, Baltimore, MD. Adam Huebner is with the Office of Global AIDS Coordination, US Peace Corps, Washington, DC
| | - Barbara Silver
- Johan H. Melendez, Tong Yu, Sarah L. Williford, Gretchen S. Armington, Barbara Silver, Charlotte A. Gaydos, and Yukari C. Manabe are with the Johns Hopkins School of Medicine, Baltimore, MD. Elizabeth A. Gilliams and Matthew M. Hamill are with the Baltimore City Health Department, Baltimore, MD. Adam Huebner is with the Office of Global AIDS Coordination, US Peace Corps, Washington, DC
| | - Adam Huebner
- Johan H. Melendez, Tong Yu, Sarah L. Williford, Gretchen S. Armington, Barbara Silver, Charlotte A. Gaydos, and Yukari C. Manabe are with the Johns Hopkins School of Medicine, Baltimore, MD. Elizabeth A. Gilliams and Matthew M. Hamill are with the Baltimore City Health Department, Baltimore, MD. Adam Huebner is with the Office of Global AIDS Coordination, US Peace Corps, Washington, DC
| | - Charlotte A Gaydos
- Johan H. Melendez, Tong Yu, Sarah L. Williford, Gretchen S. Armington, Barbara Silver, Charlotte A. Gaydos, and Yukari C. Manabe are with the Johns Hopkins School of Medicine, Baltimore, MD. Elizabeth A. Gilliams and Matthew M. Hamill are with the Baltimore City Health Department, Baltimore, MD. Adam Huebner is with the Office of Global AIDS Coordination, US Peace Corps, Washington, DC
| | - Yukari C Manabe
- Johan H. Melendez, Tong Yu, Sarah L. Williford, Gretchen S. Armington, Barbara Silver, Charlotte A. Gaydos, and Yukari C. Manabe are with the Johns Hopkins School of Medicine, Baltimore, MD. Elizabeth A. Gilliams and Matthew M. Hamill are with the Baltimore City Health Department, Baltimore, MD. Adam Huebner is with the Office of Global AIDS Coordination, US Peace Corps, Washington, DC
| | - Matthew M Hamill
- Johan H. Melendez, Tong Yu, Sarah L. Williford, Gretchen S. Armington, Barbara Silver, Charlotte A. Gaydos, and Yukari C. Manabe are with the Johns Hopkins School of Medicine, Baltimore, MD. Elizabeth A. Gilliams and Matthew M. Hamill are with the Baltimore City Health Department, Baltimore, MD. Adam Huebner is with the Office of Global AIDS Coordination, US Peace Corps, Washington, DC
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Versluis A, Schnoor K, Chavannes NH, Talboom-Kamp EP. Direct Access for Patients to Diagnostic Testing and Results Using eHealth: Systematic Review on eHealth and Diagnostics. J Med Internet Res 2022; 24:e29303. [PMID: 35019848 PMCID: PMC8792777 DOI: 10.2196/29303] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/14/2021] [Accepted: 12/01/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The number of people with chronic diseases and the subsequent pressure on health care is increasing. eHealth technology for diagnostic testing can contribute to more efficient health care and lower workload. OBJECTIVE This systematic review examines the available methods for direct web-based access for patients to diagnostic testing and results in the absence of a health care professional in primary care. METHODS We searched the PubMed, Embase, Web of Sciences, Cochrane Library, Emcare, and Academic Search Premier databases in August 2019 and updated in July 2021. The included studies focused on direct patient access to web-based triage leading to diagnostic testing, self-sampling or testing, or web-based communication of test results. A total of 45 studies were included. The quality was assessed using the Mixed Methods Appraisal Tool. RESULTS Most studies had a quantitative descriptive design and discussed a combination of services. Diagnostic test services mainly focused on sexually transmitted infections. Overall, the use was high for web-based triage (3046/5000, >50%, who used a triage booked a test), for self-sampling or self-testing kits (83%), and the result service (85%). The acceptability of the test services was high, with 81% preferring home-based testing over clinic-based testing. There was a high rate of follow-up testing or treatment after a positive test (93%). CONCLUSIONS The results show that direct access to testing and result services had high use rates, was positively evaluated, and led to high rates of follow-up treatment. More research on cost-effectiveness is needed to determine the potential for other diseases. Direct access to diagnostic testing can lower the threshold for testing in users, potentially increase efficiency, and lower the workload in primary care.
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Affiliation(s)
- Anke Versluis
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.,National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
| | - Kyma Schnoor
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.,National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands.,Saltro Diagnostic Center, Utrecht, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.,National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
| | - Esther Pwa Talboom-Kamp
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.,National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands.,Saltro Diagnostic Center, Utrecht, Netherlands
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Documentary quality versus veracity of information of the websites on syphilis and gonorrhea. Scientometrics 2021. [DOI: 10.1007/s11192-021-04123-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AbstractObjective: Analyze the possible relation between the documentary quality (DQ) versus the veracity of information (VI) on the syphilis and gonorrhea web pages. Methods: Descriptive cross-sectional study of websites containing information about syphilis and gonorrhea, by accessing this population through a Google. The quality was studied by using 8 variables belonging to DQ and 7 variables of the VI. Results: A total of 440 active websites mainly belonging to mass media and private entities was assessed. The fulfillment of DQ gave the following results: Mean 3.46 ± 0.07, median 4 and range from 0 to 7. The VI result was: median 4.07 ± 0.09, median 4 and range from 0 to 7. According to the search athwart syphilis or gonorrhea, the contrast of the median of the two indicators was: 3.55 vs 3.37 p = 0.181 and 4.14 vs 4.00 p = 0.442. No correlation was verified amid the data of DQ and VI (R = 0.04); p = 0.368. Similarly, no significance was observed when segregating data by disease, in the case of syphilis R = -0.03; p = 0.625 and on gonorrhea R = 0.12; p = 0.064. Conclusions: The DQ and VI bestowed low outcomes, which implies poor quality of syphilis and gonorrhea websites. According to infection (syphilis or gonorrhea), there were no meaningful differences amid the median values of the two indicators. Being acquainted with the authorship and affiliation of a website and the fact that it is tied to a prestigious web may be a factor to be deemed when predicting the VI of a website. The correlation amid the two indicators did not demonstrate an association, thus, knowing the DQ does not imply having the security of an adequate VI.
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Detection of Three Sexually Transmitted Infections by Anatomic Site: Evidence From an Internet-Based Screening Program. Sex Transm Dis 2021; 47:243-245. [PMID: 32004254 DOI: 10.1097/olq.0000000000001139] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Urogenital and rectal specimens collected from the "IWantTheKit" Internet-based sexually transmitted infection screening program were evaluated for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Of 881 paired specimens submitted from August 2013 to December 2016, 15.0% (n = 132) tested positive for 1 or more sexually transmitted infections, of which 50.8% (n = 67) were identified exclusively through rectal testing.
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"I'll Just Pick It Up…": Women's Acceptability of Self-Sampling Methods for Sexually Transmitted Infection Screening. Sex Transm Dis 2020; 46:762-767. [PMID: 31688722 DOI: 10.1097/olq.0000000000001077] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Rates of sexually transmitted infection (STI) screening are suboptimal among college women. Self-sampling methods (SSMs) may improve STI screening rates, but critical gaps remain regarding the influential characteristics of SSM to prioritize in intervention development. The purpose of this study was to explore intervention characteristics influencing the decision to adopt SSM among college women. METHODS In-depth interviews (n = 24) were conducted with sexually active college women aged 18-24 years to explore preferred intervention characteristics of SSM. Interviews were stratified by screening status (screened or not screened). The instrument was guided by constructs from the Diffusion of Innovation theory and included characteristics of SSM, such as relative advantage, compatibility, complexity, adaptability, and risk and uncertainty. RESULTS Overall, women felt that the SSM was not complex and that the instructions were straightforward. Participants discussed their strong preference for receiving their results via text or e-mail rather than via telephone. In addition, women described their concerns about mailing their sample and described their concern about potential contamination and tampering. The most salient advantage to use of SSM was avoiding an interaction with a health care provider. CONCLUSIONS This study contributes to an understanding of the salient intervention characteristics influencing the use of SSM for STI screening, which can be leveraged to improve the health of students and improve rates of screening. Findings can be used to inform the development of a future innovative, theory-based intervention that promotes the use of SSM to improve STI screening rates, and ultimately decrease the burden of STI-related disease.
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Gaydos CA, Barnes M, Holden J, Silver B, Smith R, Hardick J, Quinn TC. Acceptability and feasibility of recruiting women to collect a self-administered vaginal swab at a pharmacy clinic for sexually transmissible infection screening. Sex Health 2020; 17:392-394. [PMID: 32829744 DOI: 10.1071/sh20077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/26/2020] [Indexed: 11/23/2022]
Abstract
Willingness to self-collect vaginal swabs at a pharmacy clinic is of interest as a venue to increase sexually transmissible infections (STIs) screening for chlamydia, gonorrhoea and trichomonas. Women self-collected vaginal swabs at the pharmacy, completed questionnaires and received STI results within 2 h. Women with STIs were offered free treatment. A total of 313 of 777 (40.3%) women consented and prevalence for any STI was 3.9%. Questionnaires demonstrated acceptability for self-collection at the pharmacy, with 63% (95% CI 57.3-68) and 32.3% (95% CI 27.4-37.8) indicating they 'strongly agreed' or 'agreed' that they felt comfortable with pharmacy collection, respectively. Self-collected vaginal swabs for STI testing for women who were at a pharmacy were feasible and acceptable to women.
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Affiliation(s)
- C A Gaydos
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, 211 Preclinical Teaching Building, Fisher Center, 725 North Wolfe Street, Baltimore, MD 21205, USA; and Corresponding author.
| | - M Barnes
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, 211 Preclinical Teaching Building, Fisher Center, 725 North Wolfe Street, Baltimore, MD 21205, USA
| | - J Holden
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, 211 Preclinical Teaching Building, Fisher Center, 725 North Wolfe Street, Baltimore, MD 21205, USA
| | - B Silver
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, 211 Preclinical Teaching Building, Fisher Center, 725 North Wolfe Street, Baltimore, MD 21205, USA
| | - R Smith
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, 211 Preclinical Teaching Building, Fisher Center, 725 North Wolfe Street, Baltimore, MD 21205, USA
| | - J Hardick
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, 211 Preclinical Teaching Building, Fisher Center, 725 North Wolfe Street, Baltimore, MD 21205, USA
| | - T C Quinn
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, 211 Preclinical Teaching Building, Fisher Center, 725 North Wolfe Street, Baltimore, MD 21205, USA; and Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA
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Abstract
New technology may soon allow individuals to test themselves for chlamydia and gonorrhea. These new self-tests might help increase screening, but they will also bring new issues for treatment, prevention, and surveillance. Providers will need to decide how to respond to patients who present after a positive screening test and how to approach partner testing and treatment. Research will be needed to identify approaches to increase screening using these tests. Laboratory-based surveillance will not capture infections if testing does not involve a laboratory, so new surveillance techniques will be needed. Self-tests are new tools that will soon be available. We should be prepared to use them.
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Ford Carleton P, Schachter S, Parrish JA, Collins JM, Crocker JB, Dixon RF, Edgman-Levitan S, Lewandrowski KB, Stahl JE, Klapperich C, Cabodi M, Gaydos CA, Rompalo AM, Manabe Y, Wang TH, Rothman R, Geddes CD, Widdice L, Jackman J, Mathura RA, Lash TB. National Institute of Biomedical Imaging and Bioengineering Point-of-Care Technology Research Network: Advancing Precision Medicine. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2016; 4:2800614. [PMID: 27730014 PMCID: PMC5052024 DOI: 10.1109/jtehm.2016.2598837] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/16/2016] [Accepted: 05/16/2016] [Indexed: 12/28/2022]
Abstract
To advance the development of point-of-care technology (POCT), the National Institute of Biomedical Imaging and Bioengineering established the POCT Research Network (POCTRN), comprised of Centers that emphasize multidisciplinary partnerships and close facilitation to move technologies from an early stage of development into clinical testing and patient use. This paper describes the POCTRN and the three currently funded Centers as examples of academic-based organizations that support collaborations across disciplines, institutions, and geographic regions to successfully drive innovative solutions from concept to patient care.
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Gaydos CA, Jett-Goheen M, Barnes M, Dize L, Hsieh YH. Self-testing for Trichomonas vaginalis at home using a point-of-care test by women who request kits via the Internet. Sex Health 2016; 13:SH16049. [PMID: 27491592 PMCID: PMC5292311 DOI: 10.1071/sh16049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 06/17/2016] [Indexed: 11/23/2022]
Abstract
We offered a point-of-care test for Trichomonas vaginalis to women via the Internet to determine if it was acceptable to women to perform the test at home. Most of the 102 participants felt that it was easy to collect the specimen, follow the instructions, and read and interpret the results for the trichomonas self-testing assay.
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Affiliation(s)
- Charlotte A. Gaydos
- 855 North Wolfe Street, 530 Rangos Building, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD 21205, USA
- 5801 Smith Ave Davis Building, Suite 3220, Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD 21209, USA
| | - Mary Jett-Goheen
- 855 North Wolfe Street, 530 Rangos Building, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Mathilda Barnes
- 855 North Wolfe Street, 530 Rangos Building, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Laura Dize
- 855 North Wolfe Street, 530 Rangos Building, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Yu-Hsiang Hsieh
- 5801 Smith Ave Davis Building, Suite 3220, Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD 21209, USA
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Smartlowit-Briggs L, Pearson C, Whitefoot P, Altamirano BN, Womack M, Bastin M, Dombrowski JC. Community-Based Assessment to Inform a Chlamydia Screening Program for Women in a Rural American Indian Community. Sex Transm Dis 2016; 43:390-5. [PMID: 27196261 PMCID: PMC5446671 DOI: 10.1097/olq.0000000000000456] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rates of chlamydial infection in American Indian/Alaska Native women in the United States are approximately 4-fold those in non-Hispanic white women. We conducted a community-based survey of self-identified American Indian/Alaska Native women 14 to 25 years of age on a reservation in the Northwestern United States to inform a chlamydia screening strategy. METHODS The anonymous survey assessed respondents' knowledge, perceptions, and preferences related to chlamydia screening, results receipt, and partner notification. We recruited women using respondent-driven sampling, school-based sampling, and direct recruitment through social media and fliers. Participants in schools completed the survey as a paper-based, self-administered survey. Other participants could complete the survey in person, by phone as an interviewer-administered survey, or online. RESULTS We recruited 162 participants, most in schools (n = 83; 51%) or by peer referral (n = 55; 34%). Only 1 woman completed the survey online. Thirty-one respondents (19%) reported a history of an unplanned first pregnancy, and 19 (12%) reported a history of a diagnosed sexually transmitted disease. Most women (n = 98; 63%) recognized the potential impact of Chlamydia trachomatis on fertility. The preferred site for chlamydia screening was the Indian Health Service Clinic (n = 114; 70%), but 79 women (41%) would accept a C. trachomatis test at a nonclinical testing site. Of the 56 women (35%) who would accept home testing, most preferred to get the test kit from a clinic. CONCLUSIONS Our results suggest that Indian Health Service efforts to increase chlamydia screening in the clinic and through outreach may be more successful than promotion of home testing in this population.
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Affiliation(s)
| | - Cynthia Pearson
- Indigenous Wellness Research Center, University of Washington, Seattle, WA
- Toppenish School District, Toppenish, WA
| | | | | | | | - Marie Bastin
- Indian Health Services, Yakama Nation, Toppenish, WA
| | - Julia C. Dombrowski
- Center for AIDS and STD, University of Washington, Seattle, WA
- Public Health–Seattle & King County HIV/STD Program, Seattle, WA
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