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Acceptability and Feasibility of a Telehealth Intervention for Sexually Transmitted Infection Testing Among Male
Stephen Sullivan1, Patrick Sullivan2, Rob Stephenson1,3
1Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, United States.
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, especially chlamydia and gonorrhea. While research has indicated main partners over casual partners may play a central role in STI risk, the frequency of STI screening among MSM couples is particularly low. Self-sample collection for chlamydia 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 chlamydia 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:
The objective of this study was to assess the feasibility and acceptability of an at-home chlamydia and gonorrhea sample collection and remote lab testing program among a sample of 50 MSM couples living in the United States.
Methods:
This pilot study enrolled 50 MSM couples, ranging from 18-40 years old and living in the United States, who participated in a larger at-home HIV testing randomized controlled trial. Participating couples completed a pretest 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 chlamydia and gonorrhea lab testing. For participants who completed any sample collection, they received their results via a posttest video call. All participants 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, 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 a total of 50 couples have been enrolled. Overall, 49/50 couples have returned their samples and completed the posttest delivery call, and 10 in-depth interviews have been completed and transcribed.
Conclusions:
Screening MSM couples at home for chlamydia and gonorrhea and providing video-facilitated results delivery may offer a tailored approach to address the increasing prevalence of these 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.
International Registered Report Identifier (Irrid):
DERR1-10.2196/14481.
Insights
At-home chlamydia and gonorrhea screening is feasible and acceptable for men who have sex with men (MSM) couples. This pilot study shows promise for improving STI testing frequency and access within these partnerships.
Area of Science:
- Public Health
- Sexual Health
- Clinical Trials
Background:
- Gay, bisexual, and other men who have sex with men (MSM) face higher risks for sexually transmitted infections (STIs) in the U.S., particularly chlamydia and gonorrhea.
- STI screening rates are low among MSM couples, despite evidence suggesting main partners influence STI risk.
- At-home STI testing, including self-sample collection for chlamydia and gonorrhea, is accurate and acceptable in diverse populations.
Purpose of the Study:
- To assess the feasibility and acceptability of an at-home chlamydia and gonorrhea testing program for 50 MSM couples in the U.S.
- To evaluate the viability of at-home STI screening as an intervention for MSM couples.
Main Methods:
- Pilot study involving 50 MSM couples (ages 18-40) participating in an at-home HIV testing trial.
- Couples received pretest counseling via video call, then opted for at-home sample collection (rectal, pharyngeal, urine) for remote chlamydia and gonorrhea testing.
- Post-test results were delivered via video call, followed by online surveys on satisfaction, acceptability, and future willingness to test at home. A subset of 10 couples underwent in-depth interviews.
Main Results:
- 50 couples were enrolled, with 49/50 returning samples and completing post-test calls.
- 10 in-depth interviews were completed and transcribed, providing qualitative insights into the testing experience.
- Data on satisfaction, acceptability, and logistics were collected from all participants.
Conclusions:
- At-home chlamydia and gonorrhea screening with video-facilitated results delivery offers a tailored approach for MSM couples.
- This approach can help address the rising prevalence of these STIs among MSM.
- Findings will inform public health interventions and research on STI service delivery for MSM couples.
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