Preferences and Acceptability Related to Self-Administered and At-Home Testing Among Clients at Chicago Department of...

Chicago has high rates of sexually transmitted infections (STIs), disproportionately affecting vulnerable populations. Self-administered at-home testing (SAAHT) may improve access to STI testing. Before SAAHT services are made available at Chicago Department of Public Health (CDPH) STI clinics, understanding characteristics of persons who might be less likely to use SAAHT can help CDPH anticipate where extra effort might be needed to improve service utilization.

A cross-sectional survey was conducted from July to September 2023 at CDPH STI Specialty Clinics in Lakeview and South Austin. Participants (≥18 years of age) completed surveys on SAAHT acceptability. Factor analysis and modified Poisson regression identified factors associated with the likelihood of not using SAAHT.

Reported unlikelihood of using SAAHT methods was more prevalent among person who were male, heterosexual, and non-Hispanic Black/African American, and those unemployed or without postsecondary education. Being unlikely to use SAAHT methods was inversely related to perceptions of SAAHT convenience, result trustworthiness, and self-confidence in using SAAHT methods.

Findings indicate a general acceptability of SAAHT among CDPH clients, with respondents reporting being at least somewhat likely to use SAAHT regardless of the procedures involved. Unlikelihood of using SAAHT methods was related to demographic characteristics and perceptions of SAAHT, and associations differed according to method of collection, logistics of returning test kits, and mode of receiving results. Addressing method-specific concerns, providing culturally relevant education, and offering alternative sampling techniques could improve acceptability. Future efforts should explore preferences to better tailor interventions, ultimately enhancing SAAHT uptake and STI testing access in urban settings.