JMIR Publications

ABSTRACT

Background:

Gay, bisexual, and other men who have sex with men (MSM) are at elevated risk for acquiring sexually transmitted infections (STIs) in the United States (U.S.) especially chlyamida and gonorrhea. While research has indicated main partners may play a central role in STI risk over casual partners, the frequency of STI screening among MSM couples is particularly low. Self-sample collection for chlyamdia and gonorrhea screening has been shown to be highly accurate and at-home STI testing has been shown to be highly acceptable among diverse populations. However, there is little research exploring the feasibility and acceptability of at-home chlyamdia and gonorrhea screening among MSM couples. Our pilot study aims to help evaluate the viability of this screening modality as an intervention tool for MSM couples.

Objective:

To assess the feasibility and accepatiblity of an at-home chlyamida and gonorrhea sample collection and remote lab testing program among a sample of 50 MSM couples living in the U.S.

Methods:

This pilot study enrolled 50 MSM couples living in the U.S. ages 18-40 years old who participated in a larger at-home HIV testing randomized controlled trial. Participating couples completed a pre-test instructional video call and then had the option of completing at-home sample collection across three bodily sites (rectal swab, pharyngeal swab, and urine sample) for remote chlyamida and gonorrhea lab testing. For participants who completed any sample collection, they received their results via a post-test video call. All particpants completed an online survey examining satisfaction and acceptability of the home testing process, experience with logistics, willingness to test at home in the future, recent sexual risk behavior, and STI-testing history and linkage to care. A subset of 10 couples completed an in-depth interview about their attitudes towards the sample collection process, different decisions they made while collecting their samples, and their experience accessing treatment for those who received a positive result.

Results:

Recruitment began in September 2017 and as of March 2019, we enrolled 50 couples. Forty nine of the 50 couples have returned their samples and completed the post-test delivery call. Ten in-depth interviews have been completed and transcribed.

Conclusions:

Screening MSM couples at-home for chlamydia and gonorrhea and providing video facilitated result delivery may offer a tailored approach to address these increasing STIs. By collecting data on how MSM couples experience at-home STI screening, this project will provide valuable insight into the utility of such a service delivery program to public health interventionists and researchers alike.